caa a22 4500 605491763 CHVBK 20210128100511.0 cr unu---uuuuu 210128e20150401xx s 000 0 eng 10.1007/s10147-015-0793-8 doi (NATIONALLICENCE)springer-10.1007/s10147-015-0793-8 Clinical benefit of sequential use of endocrine therapies for metastatic breast cancer [Elektronische Daten] [Hirotaka Iwase, Yutaka Yamamoto] Sequential use of endocrine agents is common in estrogen receptor (ER)-positive metastatic breast cancer (MBC). In premenopausal women with MBC, tamoxifen and/or a luteinizing hormone-releasing hormone (LH-RH) agonist are options for endocrine treatment. Meta-analysis showed that the combination of the two agents is superior to either monotherapy. Under ovarian ablation or function-suppression, an agent used to treat postmenopausal women, such as the aromatase inhibitor (AI), fulvestrant, becomes possible as a subsequent therapy. In postmenopausal women, endocrine treatment options are widely available and an optimal sequence has not yet to be determined. Options for first-line therapy of metastatic disease include an AI for women who have received adjuvant tamoxifen, or tamoxifen for patients who have received adjuvant AI. In addition, data suggest that fulvestrant is a promising therapeutic option that has proven efficacy in the treatment of postmenopausal women with MBC. Other agents that may be used in the sequence include a steroidal AI or a progestin. Furthermore, estrogen additive therapy by with diethylstilbestrol or ethinylestradiol has recently been revived and showed a high response rate as a salvage endocrine therapy, although its mechanism of action is still unclear. Thus, sequential use of endocrine therapies, especially the use of a subsequent therapy with a different mechanism of action to the prior therapy, has a beneficial effect in maintaining a good quality of life and extending survival for MBC with hormone responsiveness. Japan Society of Clinical Oncology, 2015 Metastatic breast cancer nationallicence Sequential endocrine therapy nationallicence Estrogen additive therapy nationallicence Iwase Hirotaka Department of Breast and Endocrine Therapy, Kumamoto University, 1-1-1 Honjo, Chuo-Ku, 860-8556, Kumamoto, Japan aut Yamamoto Yutaka Department of Breast and Endocrine Therapy, Kumamoto University, 1-1-1 Honjo, Chuo-Ku, 860-8556, Kumamoto, Japan aut International Journal of Clinical Oncology Springer Japan 20/2(2015-04-01), 253-261 1341-9625 20:2<253 2015 20 10147 https://doi.org/10.1007/s10147-015-0793-8 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 review-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s10147-015-0793-8 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Iwase Hirotaka Department of Breast and Endocrine Therapy, Kumamoto University, 1-1-1 Honjo, Chuo-Ku, 860-8556, Kumamoto, Japan aut NATIONALLICENCE 700 1- Yamamoto Yutaka Department of Breast and Endocrine Therapy, Kumamoto University, 1-1-1 Honjo, Chuo-Ku, 860-8556, Kumamoto, Japan aut NATIONALLICENCE 773 0- International Journal of Clinical Oncology Springer Japan 20/2(2015-04-01), 253-261 1341-9625 20:2<253 2015 20 10147