Combination endocrine therapy has long been sought after as a means to better treat @entity0 . Agents that suppress @entity172 production are given with agents that suppress estrogenic activity at the cellular level. Historically, these combinations have resulted in initial improvements in response rates, but relapse-free and overall survival were not significantly improved. Also, the increased @entity137 seen with these regimens was limiting. New endocrine therapies with more potent activity and less @entity137 have led to a resurgence of this idea in the management of @entity0 . Complete @entity172 blockade has been compared with single-agent treatments in many different settings. The endocrine effects of this type of therapy are intriguing, but apparently do not readily predict a clinical advantage. The combination of an aromatase inhibitor and an antiestrogen, despite pharmacokinetic interactions, may prove to be beneficial. Results from ongoing trials are eagerly awaited to further address this question in @entity0 @entity1 . For @entity0 @entity1 the options are more complex. Clinical outcomes with @entity4396 ( @entity4396 ) agonists plus aromatase inhibitors are limited to very small phase II studies and are not clearly superior to single-agent therapy. Clinical data in the metastatic setting with premenopausal @entity1 favor the use of an @entity4396 agonist with @entity440 over the use of an @entity4396 agonist alone. However, a similar comparison with @entity440 alone is lacking with only one trial including this as a treatment arm. Adjuvant therapy with this combined endocrine approach ( @entity4396 agonist plus antiestrogen) has been more extensively studied, but lacks crucial comparisons necessary for making complex treatment decisions. Hopefully, through investigative diligence and ingenuity this issue can be adequately understood. However, many exciting new agents are on the horizon that offer hope to further advance the progress made to date although further confounding the questions already answered.

Combination endocrine therapy in the management of XXXX .

@entity172 :: ('MESH:D004967', 'Chemical') :: ['estrogen'] @entity1 :: ('9606', 'Species') :: ['patients'] @entity4396 :: ('2796', 'Gene') :: ['leutinizing hormone releasing hormone', 'LHRH'] @entity137 :: ('MESH:D064420', 'Disease') :: ['toxicity'] @entity0 :: ('MESH:D001943', 'Disease') :: ['postmenopausal breast cancer', 'breast cancer', 'premenopausal breast cancer'] @entity440 :: ('MESH:D013629', 'Chemical') :: ['tamoxifen']
@entity0 :: (MESH:D001943,Disease) :: ['breast cancer']
