A Pilot Study Comparing the Effect of Flaxseed, Aromatase Inhibitor, and the Combination on Breast Tumor Biomarkers

They can suggest resources to help pay for the drug or treatment options other than exemestane. These may include other generic medications that may be less expensive but still effective for your condition, such as Femara (letrozole) or Arimidex (anastrozole). Overall our findings indicate tamoxifen to be cost-ineffective when compared to AI monotherapy and switch therapy. When compared to switch therapy, AI for five years has an incremental cost of ₹259,792 per QALY gained, which is above the threshold for cost-effectiveness in India.

Why are aromatase inhibitors superior to tamoxifen?

In a trial comparing neoadjuvant letrozole with tamoxifen, the mammographic complete response rate with letrozole, although very low, was still higher than that observed for tamoxifen (20). Neoadjuvant antihormonal therapy with an AI is a particularly attractive option for postmenopausal women who wish to attempt breast conservation and have strongly ER- and PgR-positive tumours that are ≥ 3 cm and have low proliferation rates. For women with newly diagnosed hormone receptor positive ER+ cancers requiring systemic adjuvant therapy, 5 years of tamoxifen reduces the relative odds of recurrence by 40% and relative risk of death from breast cancer by 34% (10). At 15 years this equates to about a 12% absolute reduction in recurrence and a 9% absolute reduction in mortality, irrespective of nodal status. However, about a third of women diagnosed with ER-positive breast cancer will ultimately relapse despite adjuvant tamoxifen with or without chemotherapy (10). Women with hormone receptor-positive disease that has metastasised to organ sites distant from the breast almost always relapse following first-line antihormonal therapy with tamoxifen.

• It is a type of hormonal therapy that works by blocking the enzyme aromatase, which is responsible for converting androgens into estrogen in postmenopausal women.
• It is an important component of personalized treatment plans and can significantly improve outcomes for eligible patients.
• Currently, no peer reviewed phase III data are published and available for exemestane, but the data outlined above indicate generally longer durations of response to AIs as compared with tamoxifen.
• Finally, clinicians must be alert of the correlation between endocrine therapy and the wide spectrum of rheumatic disorders.
• However, about a third of women diagnosed with ER-positive breast cancer will ultimately relapse despite adjuvant tamoxifen with or without chemotherapy (10).

There have been cases of patients subsequently treated with a different AI or tamoxifen without recurrence of vasculitis or autoimmune/connective tissue disorders (Woodford et al., 2019). A 2018 study in the Journal of Best Fat Burner buy Clinical Oncology also noted that the risk of diabetes was 240% greater in women on aromatase inhibitors than in the general population. Although the risk was far lower with tamoxifen, aromatase inhibitors do not pose the risk of thromboembolism (blood clots) or endometrial cancer that tamoxifen does. Aromatase inhibitor treatment is started after primary treatment is complete.

Introduction to Aromatase Inhibitor Therapy

Unlike other breast cancer treatments, such as chemotherapy or targeted therapy, aromatase inhibitors specifically target the production of estrogen in the body. They are only effective in postmenopausal women because the ovaries are the main source of estrogen in premenopausal women. Red wine is an ancient and important part of global culture and health, but it has posed methodology challenges in terms of clinical investigation.

Relative to the pharmacokinetic profile of anastrozole and letrozole, genetic polymorphisms may induce differences in the metabolic profile of aromatase inhibitors, primarily identified for letrozole. The CYP2A6 and CYP3A isoforms may have their activity increased or decreased because of polymorphisms. With respect to CYP2A6, intermediate and slow metabolizers exhibit higher letrozole plasma concentrations (38). One of the polymorphisms involving CYP2A6 is related to the genetic variation across different ethnic populations. The percentage of slow metabolizers in the Asian population is larger (10-20%) when compared to Caucasians (1.2%) (39). The most common one induces an increase in enzyme activity and has a higher prevalence among black (66.7%) as compared to white subjects (4.2%) (40).

Bone-strengthening therapy

Statistical significance was measured by marginal t-test vs placebo group. For assessment of effects on steroid and growth hormone metabolism, fasting whole blood samples were obtained by trained phlebotomists using a standardized phlebotomy protocol during the baseline enrollment visit and on the morning of surgical resection. To monitor compliance with the flaxseed arms of the study, overnight urine collections were obtained at baseline and the evening immediately prior to surgery. Blood and urine were processed within an hour of collection and frozen at −80ºC in the Division of Cancer Prevention Biorepository until assay.