OnCo
termsTerm

Aromatase inhibitor

aka aromatase inhibitors, aromatase inhibition, ovarian suppression, ovarian function suppression, OFS, extended endocrine therapy, adjuvant endocrine therapy, endocrine therapy

Pills that stop the body making oestrogen (after the menopause, when it comes from fat and muscle rather than the ovaries), starving hormone receptor-positive breast cancer. Taken for five to ten years after surgery, they halve recurrence.

Letrozole, anastrozole and exemestane block the aromatase enzyme; in premenopausal women they only work with ovarian function suppression (GnRH agonist or oophorectomy, SOFT/TEXT). They modestly beat tamoxifen in postmenopausal adjuvant therapy (ATAC, BIG 1-98) and are the partner drug for CDK4/6 inhibitors in metastatic disease. Side effects are joint pain, bone loss (needing bisphosphonates), vaginal dryness and cardiovascular effects, and adherence over 5-10 years is a real problem. Resistance often comes through ESR1 mutations, which favour switching to a SERD.

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Treatment jargon

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