Optimal management of hormone receptor positive metastatic breast cancer in 2016
Hormone receptor positive tumors represent the most common form of breast cancer and account for most of the deaths from the disease. Endocrine therapy represents the main initial therapeutic strategy for these patients and has been associated with significant clinical benefits in a majority of pati...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2015-11-01
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| Series: | Therapeutic Advances in Medical Oncology |
| Online Access: | https://doi.org/10.1177/1758834015608993 |
| _version_ | 1818203706427965440 |
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| author | Tomas Reinert Carlos H. Barrios |
| author_facet | Tomas Reinert Carlos H. Barrios |
| author_sort | Tomas Reinert |
| collection | DOAJ |
| description | Hormone receptor positive tumors represent the most common form of breast cancer and account for most of the deaths from the disease. Endocrine therapy represents the main initial therapeutic strategy for these patients and has been associated with significant clinical benefits in a majority of patients. While in early stages endocrine therapy is administered as part of a curative approach once clinical metastases develop, the disease is considered incurable and the main management objectives are tumor control and quality of life. The two major clinical paradigms of always indicating endocrine therapy in the absence of visceral crises and sequencing endocrine treatments have been guiding our therapeutic approach to these patients. However, for many decades, we have delivered endocrine therapy with a ‘one size fits all’ approach by applying agents that interfere with hormone receptor signaling equally in every clinical patient scenario. We have been unable to incorporate the well-known biologic principle of different degrees of hormone receptor dependency in our therapeutic recommendations. Recent developments in the understanding of molecular interactions of hormone signaling with other important growth factor, metabolic and cell division pathways have opened the possibility of improving results by modulating hormone signaling and interfering with resistance mechanisms yet to be fully understood. Unfortunately, limitations in the design of trials conducted in this area have made it difficult to develop predictive biomarkers and most of the new combinations with targeted agents, even though showing improvements in clinical endpoints, have been directed to an unselected population of patients. In this review we explore some of the current and most relevant literature in the management of hormone receptor positive advance breast cancer. |
| first_indexed | 2024-12-12T03:29:36Z |
| format | Article |
| id | doaj.art-17f0cf3b06bd449286ffc29e96c9a7db |
| institution | Directory Open Access Journal |
| issn | 1758-8340 1758-8359 |
| language | English |
| last_indexed | 2024-12-12T03:29:36Z |
| publishDate | 2015-11-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Therapeutic Advances in Medical Oncology |
| spelling | doaj.art-17f0cf3b06bd449286ffc29e96c9a7db2022-12-22T00:39:57ZengSAGE PublishingTherapeutic Advances in Medical Oncology1758-83401758-83592015-11-01710.1177/1758834015608993Optimal management of hormone receptor positive metastatic breast cancer in 2016Tomas ReinertCarlos H. BarriosHormone receptor positive tumors represent the most common form of breast cancer and account for most of the deaths from the disease. Endocrine therapy represents the main initial therapeutic strategy for these patients and has been associated with significant clinical benefits in a majority of patients. While in early stages endocrine therapy is administered as part of a curative approach once clinical metastases develop, the disease is considered incurable and the main management objectives are tumor control and quality of life. The two major clinical paradigms of always indicating endocrine therapy in the absence of visceral crises and sequencing endocrine treatments have been guiding our therapeutic approach to these patients. However, for many decades, we have delivered endocrine therapy with a ‘one size fits all’ approach by applying agents that interfere with hormone receptor signaling equally in every clinical patient scenario. We have been unable to incorporate the well-known biologic principle of different degrees of hormone receptor dependency in our therapeutic recommendations. Recent developments in the understanding of molecular interactions of hormone signaling with other important growth factor, metabolic and cell division pathways have opened the possibility of improving results by modulating hormone signaling and interfering with resistance mechanisms yet to be fully understood. Unfortunately, limitations in the design of trials conducted in this area have made it difficult to develop predictive biomarkers and most of the new combinations with targeted agents, even though showing improvements in clinical endpoints, have been directed to an unselected population of patients. In this review we explore some of the current and most relevant literature in the management of hormone receptor positive advance breast cancer.https://doi.org/10.1177/1758834015608993 |
| spellingShingle | Tomas Reinert Carlos H. Barrios Optimal management of hormone receptor positive metastatic breast cancer in 2016 Therapeutic Advances in Medical Oncology |
| title | Optimal management of hormone receptor positive metastatic breast cancer in 2016 |
| title_full | Optimal management of hormone receptor positive metastatic breast cancer in 2016 |
| title_fullStr | Optimal management of hormone receptor positive metastatic breast cancer in 2016 |
| title_full_unstemmed | Optimal management of hormone receptor positive metastatic breast cancer in 2016 |
| title_short | Optimal management of hormone receptor positive metastatic breast cancer in 2016 |
| title_sort | optimal management of hormone receptor positive metastatic breast cancer in 2016 |
| url | https://doi.org/10.1177/1758834015608993 |
| work_keys_str_mv | AT tomasreinert optimalmanagementofhormonereceptorpositivemetastaticbreastcancerin2016 AT carloshbarrios optimalmanagementofhormonereceptorpositivemetastaticbreastcancerin2016 |