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Aromatase inhibition in male breast cancer patients: Biological and clinical implications
Annals of Oncology, 10/29/09

Doyen J et al. – The role of aromatase inhibitors (AIs) and their impact on estradiol (E2) levels remain unknown in male breast cancer (MBC) patients. AIs are active in MBC patients. This activity is correlated with a significant reduction in E2 levels. Secondary resistance is in part related to a deleterious feedback loop resulting in a significant increase in substrate for aromatization.

Methods

MBC patients with metastatic disease and those treated with AIs selected from breast cancer database of Centre Antoine-Lacassagne
Sex hormone levels retrospectively assessed on serum samples from our institutional serum bank

Results

15 patients
2 patients (13%) had complete response, 4 patients (27%) had partial response, 2 patients (13%) had stable disease and 7 patients (47%) had progressive disease
Median PFS and overall survival were 4.4 months [95% confidence interval (CI) 0.1–8.6] and 33 months (95% CI 18.4–47.6), respectively
All assessable patients (n = 6) had E2 levels less than lower limit of assay during AI treatment
3 had partial response, 1 had stable disease and 2 had progressive disease
Large increase in follicle-stimulating hormone, LH and E2 levels observed in 1 responding patient at progression