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Old 01-31-2011
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Drug Why not Anastrozole in premenopausal women

why only used for postmonopausal ? why not for women with estrogen+ receptor breat cancers PRE-monopausal??
thanks
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Old 01-31-2011
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Anastozole affects extraglandular estrogen production (the source of estrogen in postmenopausal women), rather than ovarian estrogen (the main source in pre-menopausal women), so it would have little effect in a premenopausal woman. Perhaps you might use it in an obese pre- or peri-menopausal pt... (correct me if I'm wrong, seniors )
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Old 01-31-2011
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Arrow Anastrozole is used in premenopausal women

It is also used in premenopausal women as well!
Here
http://ar.iiarjournals.org/content/28/5A/2819.abstract
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Quote:
Originally Posted by Hokolesqua
It is also used in premenopausal women as well!
Here ar.iiarjournals.org/content/28/5A/2819.abstract
Ah, I see - as an adjuvant with concurrent gonadal suppression.
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Old 01-31-2011
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Default Anastrozole can be used in pre-menopausal women as well

-anastrozole is an 'aromatase inhibitor, used in treatment of breast cancer.
-the enzyme aromatase is found in a number of human tissues and cells, including ovarian granulosa cells, the placental syncytio-trophoblast, adipose and skin fibroblasts, bone, and the brain, and it locally catalyzes the conversion of C(19) steroids to estrogens.
-aromatase expression in adipose tissue and possibly the skin primarily accounts for the extraglandular (peripheral) formation of estrogen
-fibroblasts at the tumor site in breast cancer tend to synthesize higher levels of aromatase.
-androstenedione is aromatised to estradione which subsequently is converted into estradiol in extra-glandular (peripheral) sites such as adipose tissue and skin fibroblasts. Estradiol produced in this manner is the cause of tumor growth, more so in post menopausal women than premenopausal women. Thus, anastrozole is more useful in former cases, but can also be used in latter cases.
-it is highly effective on estrogen receptor positive tumors.
- used in pre-menopausal (as well as post-menopausal women) after mastectomy, to treat metastases.
-also used alone or in combination with tamoxifen, in the pre-menopausal patients who do not respond to tamoxifen alone.
-can also be used safely in treatment of benign prostatic hyperplasia and gynaecomastia in elderly men.
-most significant adverse effects include osteoporosis and hyperlipidemia, both of which can be prevented using bisphosphonates and statins.
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@dr.ram;"...Estradiol produced in this manner is the cause of tumor growth, more so in post menopausal women than premenopausal women. Thus, anastrozole is more useful in former cases,..."please explain more i do not get this part! why anastrozole is more effective for postmenopause.
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Old 01-31-2011
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Quote:
Originally Posted by Mondoshawan View Post
Anastozole affects extraglandular estrogen production (the source of estrogen in postmenopausal women), rather than ovarian estrogen (the main source in pre-menopausal women), so it would have little effect in a premenopausal woman. Perhaps you might use it in an obese pre- or peri-menopausal pt... (correct me if I'm wrong, seniors )
as far as i know anastrozole inhibits aromatase -i have not seen any where saying that it does not work inside ovarian granulosa cells -so i would expect it be helpful in premenopausal age as same as post.
please correct me if i am wrong
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Quote:
Originally Posted by hana View Post
as far as i know anastrozole inhibits aromatase -i have not seen any where saying that it does not work inside ovarian granulosa cells -so i would expect it be helpful in premenopausal age as same as post.
please correct me if i am wrong
I think that it's not that it doesn't work on the aromatase in the ovaries; rather, that while there is still ovarian estrogen production, there is also still an intact gonadotropin feedback loop to overcome the competition. I'll look into it tomorrow to make sure, and I'll post what I find out here. In the meantime, perhaps someone who knows more than we do will post the answer!
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Quote:
Originally Posted by hana View Post
@dr.ram;"...Estradiol produced in this manner is the cause of tumor growth, more so in post menopausal women than premenopausal women. Thus, anastrozole is more useful in former cases,..."please explain more i do not get this part! why anastrozole is more effective for postmenopause.
i my last reply, former= post menopausal; latter=pre menopausal. i am sorry if anyone got confused due to that.:sorry:

i want to add to previous reply that ''aromatase inhibitors preferentially act on peripheral aromatase but not the ovarian aromatase.'' as only peripheral aromatase has to be inhibitted in case of post-menopausal women, aromatase inhibitors are more useful in them, but not in pre-menoausal women.
hope this info was of help to u.
i am searching for the citation, i will let u know as soon as i find it.

please note that these drugs can also be used in pre-menopausal women, but better drugs like Tamoxifen are available for use in them, which block estrogen receptors of tumor but not other cells.

and as far as i know, details anything more than mechanism of action of aromatase inhibitors are not required for step1. but if we are in doubt, we have to get it clarified.
good work hana.
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