Endocrine Therapy Of Breast Cancer V

Adjuvant treatment is administered prior to or as follow up to surgical procedures for breast cancer. Proven success in using medical therapies allowing for breast conserving procedures or reducing risk of occurrence. Although there has been much progress towards a cure, including the introduction of new targeted therapies, metastasizing cancer remains highly incurable.

The European School of Oncology came into existence to respond to a need for informa tion, education and training in the field of the diagnosis and treatment of cancer. There are two main reasons why such an initiative was considered necessary. Firstly, the teaching of oncology requires a rigorously multidisciplinary approach which is difficult for the Univer sities to put into practice since their system is mainly disciplinary orientated. Secondly, the rate of technological development that impinges on the diagnosis and treatment of cancer has been so rapid that it is not an easy task for medical faculties to adapt their curricula flexibly. With its residential courses for organ pathologies and the seminars on new techniques (laser, monoclonal antibodies, imaging techniques etc.) or on the principal therapeutic controversies (conservative or mutilating surgery, primary or adjuvant chemotherapy, radiotherapy alone or integrated), it is the ambition of the European School of Oncology to fill a cultural and scientific gap and, thereby, create a bridge between the University and Industry and between these two and daily medical practice. One of the more recent initiatives of ESO has been the institution of permanent study groups, also called task forces, where a limited number of leading experts are invited to meet once a year with the aim of defining the state of the art and possibly reaching a consensus on future developments in specific fields of oncology.

This reference evaluates and describes the latest strategies for hormone suppression and blockade in the management of early and advanced stage breast cancer and explores the effects of tamoxifen, selective estrogen receptor modulators (SERMs), aromatase inhibitors, and their combination on both breast cancers and normal tissues. Endocrine T

This is the fifth issue of the monograph on Endocrine Therapy of Breast Cancer. The spectrum of the items is remarkably broad and includes the normal breast cell, the cancer cell, mechanisms of resistance to therapeuticagents, new endocrine treatments, the patient with breast cancer, her quality of life, and some public health issues related to the population of women with the disease. Special emphasis is given to the understanding of various biological events and mechanisms related to the effects of endocrine therapies and to mesenchymal and epithelial interactions. The clinical relevance of endocrine therapies is extensively discussed touching a broad spectrum of issues which include the search for novel endocrine treatments, prognostic factors and treatment responsiveness factors, effects of the combination of chemotherapy and endocrine therapies on patients with breast cancer, as wellas aspects of quality of life and of reporting data from trials concerned with the treatments of the disease. The field of breast cancer continuesto represent a most interesting and fertile ground for implementation of knowledge on human malignant diseases. The authors of this European School of Oncology Monograph hope that the reports included in it will be helpful for cross-fertilization between basic and clinical research in the field.

This book describes the principles underlying targeted hormonal treatments, assesses the actions of new and established agents, and illustrates the new applications of hormonal chemoprevention for breast cancer.

Starting in 1986, the European School of Oncology has expanded its activities in postgraduate teaching, which consisted mainly of traditional disease-orientated courses, by promoting new educational initiatives. One of these is the cloister seminars, short meetings intended for highly qualified oncologists and dealing with specific, controversial aspects of clinical practice and research. Another is the institution of permanent study groups, also called task forces, where a limited number of leading experts are invited to meet once a year with the aim of defining the state of the art and possibly reaching a consensus on developments and treatment in specific fields of oncology. This series of ESO Monographs was designed with the specific purpose of disseminating the results of the most interesting of the seminars and study groups, and providing concise and updated reviews of the subjects discussed. It was decided to keep the layout very simple in order to keep costs to a minimum and make the monographs available in the shortest possible time, thus overcoming a common problem in medical literature: that of the material being outdated even before publication. Umberto Veronesi Chairman, Scientific Committee European School of Oncology Table of Contents How to Read this Monograph F.CAvALLI ......... . 1 Experimental Strategies for Studying the Development of Breast Cancer with Special Reference to Steroid Hormones, Growth Factors and Oncogenes R.J.B. KING . . . . . . . . . . . . . . . . . . . . . . . . .. . . . 5 . . .

Breast cancer is one of the leading causes of cancer mortality in women worldwide, and the risk of disease recurrence continues despite improvements in screening and treatment. For patients with hormone receptor-positive breast cancer, some form of endocrine therapy is central to the management of their disease. Tamoxifen has long been the mainstay of endocrine therapy in this group of patients. However, there is mounting evidence showing that the aromatase inhibitors are able to reduce overall oestrogen levels and appear to be better tolerated over a long term than tamoxifen. New and emerging indications for the aromatase inhibitors are providing clinicans (and patients) with alternative treatment options with differing side effect profiles. Part of the Oxford Oncology Library, this pocketbook will summarise the latest evidence-based and practical information on the use of endrocrine therapies in the management of breast cancer (early stage, metastatic disease, and prevention of disease). With contributions from leading oncologists from the MD Anderson Cancer Center, the book covers the range of endocrine therapies currently available to clinicians including ovarian ablation, anti-estrogens, aromatase inhibitors, fulvestrant, progestins, androgens, and combination endocrine and chemotherapy. The book also includes useful chapters on the identification and optimal selection of patients for endocrine therapy as well as the role of endocrine treatments in the prevention of breast cancer. This book will serve as an invaluable reference for all health care professionals involved in the management of patients with breast cancer.

Progress in basic research has made it necessary to redetermine the possibility of classic endocrine therapy for the treatment of patients with breast cancer. Exemplary, close cooperation between biochemis try and animal and clinical research led to a truly interdisciplinary and international exchange of ideas and experience at a symposium held in autumn 1978 in Heidelberg. We owe our thanks to ICI-Pharma for the kind support of this sym posIUm. The participation of Charles Huggins in the meeting as honorary chairman signified to all participants the meaning of this joint endeavour. It was the same Charles Huggins who through experimental work laid the foundation stone for endocrine ther apy of prostate and breast cancer, and who applied his findings clinically. Thousands of patients owe to him relief from their suffering. He contributed greatly to the attempt to find and stabilize the endocrine therapy for breast cancer, for which we thank him sincerely. We hope that the following contributions will similarly serve the well-being of our patients.