Journal of Modern OncologyJournal of Modern OncologyСовременная онкология1815-14341815-1442LLC Obyedinennaya Redaktsiya26671ArticlesСтатьиResearch ArticleFemara (letrozol) v ad\"yuvantnoy terapii raka molochnoy zhelezyФемара (летрозол) в адъювантной терапии рака молочной железыSteninaM BСтенинаМ БГУ РОНЦ им. Н.Н.Блохина РАМН, Москва1509200793VOL 9, NO3 (2007)ТОМ 9, №3 (2007)91209042020Copyright ©; 2007, Consilium MedicumCopyright ©; 2007, ООО "Консилиум Медикум"2007Consilium MedicumООО "Консилиум Медикум"https://creativecommons.org/licenses/by-nc/4.0https://modernonco.orscience.ru/1815-1434/article/view/26671

Группа ингибиторов ароматазы (ИА) 3-го поколения включает два обратимых нестероидных ингибитора: летрозол (Фемара) и анастрозол (Аримидекс) – и необратимый стероидный инактиватор экземестан (Аромазин). Эти препараты убедительно продемонстрировали преимущества в эффективности и токсичности по сравнению с тамоксифеном при лечении диссеминированного гормонозависимого рака молочной железы (РМЖ) как в первой линии гормонотерапии, так и при резистентности к другим препаратам гормонотерапии. В настоящее время изучается их действие при лечении больных ранним РМЖ. В данной статье мы рассмотрим результаты исследований, посвященных оценке эффективности Фемары в адъювантной гормонотерапии рецепторпозитивного РМЖ у больных в менопаузе.

рак молочной железыгормонзависимые опухолиингибиторы ароматазыадъювантная терапияФемараEarly Breast Cancer Trialistsу Collaborative Group (EBCTCG). Effects of chemotherapy and hormonal therapy for early breast cancer on recurrence and 15-year survival: an overview of the randomized trials. Lancet 2005; 365(9472): 1687–717.Fisher B, Dignam J, Bryant J, Wolmark N. Five versus more than five years of tamoxifen for lymph node - negative breast cancer: updated findings from the National Surgical Adjuvant Breast Cancer and Bowel Project B-14 randomized trial. J Natl Cancer Inst. 2001; 93(9): 684–90.Geisler J, Ekse D, Helle H, et al. Letrozole suppresses tissue and plasma estradiol, estrone and estrone sulfate more effectively compared to anastrozole. Breast Cancer Res Treat 100 (Suppl. 1), S23 (2006) (Abstract 103).Dixon J.M, Renshaw L, Young O, et al. Letrozole suppresses plasma oestradiol (E2) levels more completely than anastrozole in postmenopausal women with breast cancer. J Clin Oncol. 2006; 24(18S): 15s.Rose C, Vtoraya O, Pluzanska A, et al. An open randomized trial of second - line endocrine therapy in advanced breast cancer. Comparison of the aromatase inhibitors letrozole and anastrozole. Eur J Cancer 2003; 39: 2318–27.Mourisden H, Gershanovich M, Sun Y, et al. Phase III study of letrozole versus tamoxifene as first line therapy of advanced breast cancer in postmenopausal women: analysis of survival and update of efficacy from the International Letrozole Breast Cancer Group. J Cancer Oncol. 2003; 21: 2101–9.Ellis M.J, Coop A, Singh B, et al. Letrozole is more effective neoadjuvant endocrine therapy than tamoxifen for ErbB-1- and/or ErbB-2-positive estrogen receptor - positive primary breast cancer: evidence from a phase III randomized trial. J Clin Oncol. 12001; 9: 3808–16.Cataliotti L, Buzdar A.U, Noguchi S, et al. Comparison of anastrozole versus tamoxifen as preoperative therapy in postmenopausal women with hormone receptor - positive breast cancer: the Preoperative "Arimidex" Compared to Tamoxifen (PROACT) trial. Cancer 2006; 106: 2095–103.Smith I.E, Dowsett M, Ebbs S.R, et al. IMPACT Trialists Group. Neoadjuvant treatment of postmenopausal breast cancer with anastrozole, tamoxifen or both in combination: the immediate preoperative anastrozole, tamoxifen or combined with tamoxifen (IMPACT) multicenter double - blind randomized trial. J Clin Oncol. 2005; 23: 5108–16.Ellis M.J, Coop A, Singh B, et al. Letrozole inhibits tumor proliferation more effectively than tamoxifen independent of HER1/2 expression status. Cancer Res. 2003; 63: 6523–31.Thurlimann B, Keshaviah A, Coates A.S, et al. for the Brest International Group (BIG) 1-98 Collaborative Group. A comparison of letrozole and tamoxifen in postmenopausal women with early breast cancer. N Engl J Med. 2005; 353: 2747–57.Monnier A.M. The Breast International Group 1-98 trial: big results for women with hormone - sensitive early breast cancer. Expert Rev Anticancer Ther. 2007; 7(5): 627–34.Coates A.S, Kashaviah A, Thurlimann B, et al. Five Years of Letrozole Compared With Tamoxifen as Initial Adjuvant Therapy for Postmenopausal Women with Endocrine-Responsive Early Breast Cancer: Update of Study BIG 1-98. JCO 2007; 25(5): 486–92.Vakaer L, Buyse M. Comparative results of two adjuvant trials comparing 5 years of an aromatase inhibitor with 5 years of tamoxifen in postmenopausal woman with early breast cancer. Breast Cancer Res Treatment. 100 (Suppl. 1), S108-S109 (2006) (Abstract 2084).Houghton J, on behalf of the ATAC Trialists' Group. Initial adjuvant therapy with ANA (S) reduced rates of early breast cancer recurrent and adverse events compared with TAM (T) - data reported on behalf of the ATAC Trialists' group. Ann Oncol. 17 (Suppl. 9), ix93 (2006) (Abstract 243D).De Boer R, Burris H.A, Monnier A, et al. The Head to Head trial: Letrozole vs. Anastrozole as adjuvant treatment of postmenopausal patients with node positive breast cancer. J Clin Oncol 2006; 24: 18S (Abstract 10672).Goss P.E, Ingle J.N, Martino S, et al. Randomized trial of letrozole following tamoxifen as extended adjuvant therapy in receptor - positive breast cancer: updated findings from NCIC CTG MA.17. J Natl Cancer Inst. 2005; 97(17): 1262–71.Goss P.E, Ingle J.N, Martino S, et al. Efficacy of Letrozole Extended Adjuvant Therapy According to Estrogen Receptor and Progesterone Receptor Status of the Primary Tumor: National Cancer Institute of Canada Clinical Trials Group MA.17. JCO 2007; 25(15).Goldhirsh A, Wood W.C, Gelber R.D, et al. Progress and promise: highlights of the international expert consensus on the primary therapy of early breast cancer 2007. Ann Oncol. 2007; 18: 1133–44.