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2012 | 2 | 3 | 173-181
Article title

Znaczenie inhibitorów aromatazy w leczeniu chorych na raka piersi

Title variants
Aromataze inhibitors in the treatment of breast cancer
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Leczenie hormonalne raka piersi ma na celu ograniczenie oddziaływania endogennych estrogenów na komórki nowotworu. Odkrycie receptorów hormonalnych i poznanie ich znaczenia umożliwiło zastosowanie hormonoterapii w celowany sposób. U kobiet po menopauzie estrogeny wytwarzane są z androgenów. Aromataza jest enzymem, który powoduje konwersję androgenów do estronu. Inhibitory aromatazy blokują syntezę estrogenów. Leki z tej grupy wykazywały aktywność w leczeniu uogólnionego raka piersi, leczeniu uzupełniającym i w leczeniu neoadiuwantowym. Inhibitory aromatazy są lekami bezpiecznymi i wygodnymi w podawaniu. U chorych na uogólnionego raka piersi są bardziej aktywne niż tamoksyfen. W leczeniu neoadiuwantowym również wykazywały aktywność większą niż tamoksyfen. W leczeniu uzupełniającym przeprowadzono badania porównujące bezpośrednio tamoksyfen z inhibitorami aromatazy. Badano również leczenie sekwencyjne polegające na podawaniu przez 2–3 lata tamoksyfenu, a następnie inhibitora aromatazy (badano również odwrotną sekwencję). W ramieniu kontrolnym przez 5 lat podawano tamoksyfen. Przeprowadzono również badania nad znaczeniem wydłużonego stosowania inhibitorów aromatazy, w których po 5-letnim leczeniu tamoksyfenem podawano inhibitor aromatazy. Wyniki tych badań i przeprowadzonych na ich podstawie metaanaliz pozwalają na rekomendowanie stosowania inhibitorów aromatazy w leczeniu uzupełniającym.
The main goal for hormonal therapy of breast cancer is to inhibit action of endogenous estrogens to breast cancer cells. Discovery of hormonal receptors and knowledge of their biological role employment to manner hormonal treatment as target therapy. Postmenopausal estrogens are synthesized from androgens, mainly androstenedione, which is converted into estrone. Aromatase inhibitors potently inhibit aromatase activity and also suppress estrogen levels in plasma and tissue. Aromatase inhibitor are safety and convenient drugs In clinical studies in postmenopausal women with breast cancer shown superior to tamoxifen for the treatment of metastatic disease, and in neoadjuvant approach Studies of adjuvant therapy with aromatase inhibitors include: head-to-head studies of the aromatase inhibitor versus tamoxifen monotherapy, sequential therapy of 2–3 years of tamoxifen followed by an aromatase inhibitor (or the opposite sequence) versus 5 years of tamoxifen monotherapy: extended therapy with an aromatase inhibitor after 5 years of tamoxifen. Aromatase inhibitors are active and are recommended in every stage of breast cancer.
Physical description
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