Q.83 Aromatase inhibitors are often prescribed for post-menopausal women to treat estrogen receptor
positive breast cancer patients, because these class of drugs
(A) reduce prostaglandin biosynthesis
(B) reduce the level of estradiol biosynthesis
(C) inhibit conversion of testosterone to dihydrotestosterone
(D) are non-toxic in post-menopausal women
Aromatase inhibitors effectively treat estrogen receptor-positive breast cancer in post-menopausal women by targeting estrogen production. The correct answer to the query is (B) reduce the level of estradiol biosynthesis, as these drugs block the enzyme responsible for converting androgens to estrogens like estradiol.
Correct Answer
Aromatase inhibitors lower circulating estrogen levels in post-menopausal women, where ovaries no longer produce estrogen and peripheral tissues rely on aromatase to convert androgens like testosterone and androstenedione into estradiol and estrone. This suppression starves hormone-dependent breast cancer cells of growth stimuli, improving outcomes in estrogen receptor-positive cases. Drugs like anastrozole, letrozole, and exemestane exemplify this class, serving as first-line therapy post-tamoxifen.
Option Breakdown
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(A) Reduce prostaglandin biosynthesis: Incorrect, as this describes non-steroidal anti-inflammatory drugs (NSAIDs) like COX inhibitors, not aromatase inhibitors which target cytochrome P450 aromatase specifically for estrogen synthesis.
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(B) Reduce the level of estradiol biosynthesis: Correct, because aromatase catalyzes the final step in estradiol production from androgens in adipose tissue, skin, and muscle of post-menopausal women.
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(C) Inhibit conversion of testosterone to dihydrotestosterone: Incorrect; 5-alpha-reductase inhibitors like finasteride perform this action for prostate conditions, unrelated to aromatase’s estrogen pathway.
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(D) Are non-toxic in post-menopausal women: Incorrect, as while effective post-menopause, these drugs cause side effects like bone loss, hot flashes, and arthralgia, requiring monitoring regardless of menopausal status.
