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Monitoring estradiol concentration following aromatase inhibitor treatement
by DaveH01, Apr 28, 2008 01:55PM
How are estradiol assays currently being used in clinical practice? How frequently are serum estradiol levels monitored (semi-annually, annually etc.) and for how long?
My understanding is that current assays which monitor estradiol levels are not sufficiently sensitive. If a sensitive assay was available would it be used to identify postmenopausal women at high-risk of developing breast cancer, as a surrogate endpoint to monitor responsiveness to current drug treatments meant to lower local/circulating hormone levels or yet another application?
From a clinical perspective, how would having a more sensitive estradiol assay alter current treatment/management of patients?
My understanding is that current assays which monitor estradiol levels are not sufficiently sensitive. If a sensitive assay was available would it be used to identify postmenopausal women at high-risk of developing breast cancer, as a surrogate endpoint to monitor responsiveness to current drug treatments meant to lower local/circulating hormone levels or yet another application?
From a clinical perspective, how would having a more sensitive estradiol assay alter current treatment/management of patients?
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The development of sensitive predictive and screening tools for the development of breast cancer is difficult. As far as I know, estradiol monitoring has not been approved for this purpose mainly due to the insensitivity of the assays and non-standardized reporting of findings. A more comprehensive cohort analysis with very large sample sizes should be done in order to prove if estradiol levels can be really predictive of breast cancer development. If levels of estradiol are proven to be predictive, and can be incorporated in the present predictive models (like the GAIL model) then it would be a great help to the medical community, since the doctors can now intervene through lifestyle or pharmacologic measures to decrease the risk. But for now, the estradiol test still has a long way to go. Regards