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Crystal S. Denlinger, Tara Sanft, K. Scott Baker, Shrujal Baxi, Gregory Broderick, Wendy Demark-Wahnefried, Debra L. Friedman, Mindy Goldman, Melissa Hudson, Nazanin Khakpour, Allison King, Divya Koura, Elizabeth Kvale, Robin M. Lally, Terry S. Langbaum, Michelle Melisko, Jose G. Montoya, Kathi Mooney, Javid J. Moslehi, Tracey O'Connor, Linda Overholser, Electra D. Paskett, Jeffrey Peppercorn, M. Alma Rodriguez, Kathryn J. Ruddy, Paula Silverman, Sophia Smith, Karen L. Syrjala, Amye Tevaarwerk, Susan G. Urba, Mark T. Wakabayashi, Phyllis Zee, Deborah A. Freedman-Cass and Nicole R. McMillian

reach menopause at a mean age of 51 years, with 95% reaching menopause between 45 and 55 years. 1 Many cancer survivors experience menopausal symptoms without meeting the definition of menopause, including female survivors on aromatase inhibitors or

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Julie R. Gralow, J. Sybil Biermann, Azeez Farooki, Monica N. Fornier, Robert F. Gagel, Rashmi N. Kumar, Charles L. Shapiro, Andrew Shields, Matthew R. Smith, Sandy Srinivas and Catherine H. Van Poznak

N Coleman R . Integrated analysis of zoledronic acid for prevention of aromatase inhibitor-associated bone loss in postmenopausal women with early breast cancer receiving adjuvant letrozole . Oncologist 2008 ; 13 : 503 – 514 . 56 Gnant

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William Gradishar and Kilian E. Salerno

%, and 68% of patients, respectively. 1 “Adjuvant endocrine therapy is a rational approach,” he said. “While this is mainly used in postmenopausal women, you can treat premenopausal women with aromatase inhibitors [AIs] as long as you render them

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Julie R. Gralow, J. Sybil Biermann, Azeez Farooki, Monica N. Fornier, Robert F. Gagel, Rashmi Kumar, Georgia Litsas, Rana McKay, Donald A. Podoloff, Sandy Srinivas and Catherine H. Van Poznak

with a family history of fractures, body weight less than 70 kg, and prior nontraumatic fracture, and those of any age who are postmenopausal receiving aromatase inhibitor (AI) therapy, and those who are premenopausal with therapy-induced ovarian

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Robert W. Carlson, Elizabeth Brown, Harold J. Burstein, William J. Gradishar, Clifford A. Hudis, Charles Loprinzi, Eleftherios Paul Mamounas, Edith A. Perez, Kathleen Pritchard, Peter Ravdin, Abram Recht, George Somlo, Richard L. Theriault, Eric P. Winer, Antonio C. Wolff and for the NCCN Adjuvant Therapy for Breast Cancer Task Force

predictive factors? Can certain subsets of premenopausal women with ER-positive tumors be adequately treated using tamoxifen and/or ovarian suppression and forego adjuvant chemotherapy? What is the optimal strategy for using aromatase inhibitors (AIs) in the

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Josh Lauring, Ben Ho Park and Antonio C. Wolff

cell lines and resensitize these cells to hormonal therapies, including tamoxifen and aromatase inhibitors. 20 , 23 , 25 - 28 In contrast, other studies have not found an increased sensitivity of LTED cells to dual PI3-kinase/mTOR inhibitors, and LTED

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Richard L. Theriault, J. Sybil Biermann, Elizabeth Brown, Adam Brufsky, Laurence Demers, Ravinder K. Grewal, Theresa Guise, Rebecca Jackson, Kevin McEnery, Donald Podoloff, Peter Ravdin, Charles L. Shapiro, Matthew Smith and Catherine H. Van Poznak

-induced ovarian failure must be carefully distinguished from menopause, because adjuvant use of aromatase inhibitors is only indicated in the absence of ovarian estrogen production. Bisphosphonate therapy can attenuate the bone loss associated with ovarian failure

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Seth A. Wander, Hyo S. Han, Mark L. Zangardi, Andrzej Niemierko, Veronica Mariotti, Leslie S.L. Kim, Jing Xi, Apurva Pandey, Siobhan Dunne, Azadeh Nasrazadani, Avinash Kambadakone, Casey Stein, Maxwell R. Lloyd, Megan Yuen, Laura M. Spring, Dejan Juric, Irene Kuter, Ioannis Sanidas, Beverly Moy, Therese Mulvey, Neelima Vidula, Nicholas J. Dyson, Leif W. Ellisen, Steven Isakoff, Nikhil Wagle, Adam Brufsky, Kevin Kalinsky, Cynthia X. Ma, Joyce O’Shaughnessy and Aditya Bardia

. Clinical Parameters Abemaciclib Use After Prior CDK4/6i Therapy Given the lack of guidance from prospective randomized trials, practice patterns differed among physicians. Most patients received palbociclib in combination with an aromatase inhibitor (AI; n

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Rodger J. Winn

This month's issue provides the journal reader with an elegant analysis of the clinical evidence substantiating the use of aromatase inhibitors (AIs) in the adjuvant treatment of breast cancer in postmenopausal women. Based on the data from 6 randomized studies, women may be treated with an AI alone, with 2 or 3 years of tamoxifen followed by an AI, or with 5 years of tamoxifen followed by another extended period of an AI. As this issue's special feature by Carlson et al. points out, the NCCN guidelines, the ASCO Technology Assessment, and the St Gallen consensus statement all recommend these 3 options. All 3 documents also state that existing data do not allow a choice among these approaches because they have not been compared head-to-head. In the broadest sense, all 3 panels agree that AIs offer a benefit, but the recommendations are not identical. The St Gallen recommendations also present a fourth option, the use of standard tamoxifen in patients at minimal or intermediate risk. The NCCN, in turn, does not recommend adjuvant treatment for very small lesions. As Baum and Ravdin1 previously observed, patients in the same clinical category could potentially be treated differently based on which clinical guideline their practitioner consulted. Why this disparity? Several differences in the guideline development process may account for it. The first and most obvious reason is that the panels can interpret data differently or attribute differing validity to the studies.2 This does not appear to be the case in this instance. A...
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Early Staged Breast Cancers: Hypothesis, Existing Data, and a Planned Phase III Trial McCormick Beryl MD 5 2005 3 3 3 3 301 301 307 307 10.6004/jnccn.2005.0017 Aromatase Inhibitors in Postmenopausal Breast Cancer Patients Rieber Alyssa G