Title:Effectiveness of Selective Estrogen Receptor Modulators in Breast
Cancer Therapy: An Update
Volume: 30
Issue: 29
Author(s): Agnidipta Das, Kanamarlapudi Joshna Lavanya, Nandini, Kamalpreet Kaur and Vikas Jaitak*
Affiliation:
- Department of Pharmaceutical Sciences and Natural Products, Central University of Punjab, Ghudda, Bathinda
(Pb), 151401, India
Keywords:
BC, ER, inhibitors, proliferation, SAR, SERMs, tamoxifen.
Abstract:
Background: Breast cancer is considered to be 2nd most common cancer subtype
investigated worldwide. It is mainly prevalent in postmenopausal women. Estrogen
Receptor (ER) is a primary transcription factor for the survival and growth of tumors.
Around 80% BCs of all classes are ER-positive (ER+). Powerful evidence for estrogen
proved to be involved in BC pathogenesis both exogenously and endogenously. It brings
the concept of ER inhibitors to treat BC with distinct mechanisms into focus and ER
PROTACs (Proteolysis-Targeting Chimeras), AIs (Aromatase inhibitors), SERMs (Selective
estrogen receptor modulators), and SERDs (Selective estrogen receptor degrader)
were developed. For over 30 years, Tamoxifen, a triphenylethylene SERM, was the drug
of choice solely to treat ER+BC patients. Although several SERMs got approval by US
FDA after tamoxifen, complicacies remain because of dangerous adverse effects like endometrial
carcinoma, hot flashes, and VTE (Venous thromboembolism). In addition to
that, drug-resistant tumors put a surging need for novel, potent candidates with no or low
adverse effects for ER+ BC prevention.
Objectives: This article explores the possibilities of SERMs as effective BC agents.
Methods: A detailed literature survey of the history and recent advancements of SERMs
has been carried out, taking BC as the primary target. This review provides information
about ER structure, signaling, pharmacological action, chemical classification with SAR
analysis, and benefits and adverse effects of SERMs as potential BC agents.
Results: Exhaustive literature studies suggested that SERMs having an agonistic, antagonistic
or mixed activity to ER could efficiently inhibit BC cell proliferation.
Conclusion: Each chemical class of SERMs comprises some salient features and potentials,
which may be further investigated to obtain novel effective SERMs in BC therapy.