Annals of Oncology 13:1835-1836, 2002
© 2002 European Society for Medical Oncology
Book Review |
A. Manni, M.F. Verderame (eds). Selective Estrogen Receptor Modulators: Research and Clinical Applications
Bergamo, Italy
A. Manni & M. F. Verderame (eds). Contemporary Endocrinology. Humana Press, Totowa, NJ, 2001, 374 pp, $198.00, £145.00, US$175.00
Selective Estrogen Receptor Modulators offers a comprehensive view into the present and the future of one of the most complex and rapidly growing area of oncology and medicine. Furthermore, it explains how an understanding of the basic science of the molecular biology of estrogen receptors and the molecular pathophysiology of breast cancer overall can lead not only to new treatments, but also to new promising and exciting applications of old and new hormonal drugs. The vast amount of information, so successfully brought together, represents this book’s strength. It is a multiauthor text, with 20 chapters and more than 1500 references compiled from 38 international contributors.
The first nine chapters are the Basic Studies section, which addresses in detail the cellular biology and molecular mechanisms of selective estrogen receptor modulators (SERMs) and describes their dual tissue-specific estrogen agonist/antagonist activities. The authors focus on important aspects, such as distinct ligand-dependent conformational changes in the estrogen receptors, which are crucial in the recruitment of coactivators and corepressors that modulate the estrogen receptors’ activity and effect on gene expression. Furthermore, the influence on critical target organs such as the cardiovascular system and the brain is also discussed in depth. The Basic Studies section offers interesting laboratory models for study of the molecular mechanism of SERMs and insight into tamoxifen resistance. Finally, Labrie et al. describe new and exciting compounds with the highest antagonistic effect and no agonistic or estrogenic-like action in breast and uterus, yet able to protect against bone loss and cardiovascular disease.
With the same clear and comprehensive detail, the Clinical section describes SERMs’ effects on the skeleton, neuroendocrine and cardiovascular systems. This section also analyses SERMs’ roles in prevention and treatment of breast cancer, cardiovascular disease, osteoporosis and cognitive impairment. In addition, an individualized approach is provided for both healthy and breast cancer survival women. The role of SERMs in clinical practice is thoroughly described and the authors remind us that SERMs show activities ranging from nearly full estrogenic activity to almost pure antiestrogenic activity. These compounds can be developed for specific therapeutic uses, ranging from treatment and prevention of osteoporosis to the prevention and/or treatment of breast cancer. These drugs offer great promise for the development of optimal hormone replacement therapy for women, an approach that might avoid stimulation of the breast, while treating menopausal symptoms effectively, reducing postmenopausal bone loss and perhaps reducing the risk of cardiac disease.
I strongly recommend this book for a wide variety of audiences: endocrinologists; medical oncologists; gynecologists; and family practitioners. Certainly, it will be enjoyable reading for everyone and an excellent and valuable source of integrated information.
M. Mandalà & S. Barni
Treviglio (Bg), Italy
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