Clinical benefit of sequential use of endocrine therapies for XXXX .

@entity1 @entity11163 @entity1782 @entity0
UNASSIGNED: Sequential use of endocrine agents is common in @entity1782 ( @entity1782 )-positive @entity0 ( @entity0 ). In premenopausal @entity1 with @entity0 , tamoxifen and/or a luteinizing hormone-releasing hormone (LH-RH) agonist are options for endocrine treatment. Meta-analysis showed that the combination of the two agents is superior to either monotherapy. Under ovarian ablation or function-suppression, an agent used to treat postmenopausal @entity1 , such as the @entity11163 ( @entity11163 ), fulvestrant, becomes possible as a subsequent therapy. In postmenopausal @entity1 , endocrine treatment options are widely available and an optimal sequence has not yet to be determined. Options for first-line therapy of metastatic disease include an @entity11163 for @entity1 who have received adjuvant tamoxifen, or tamoxifen for @entity1 who have received adjuvant @entity11163 . In addition, data suggest that fulvestrant is a promising therapeutic option that has proven efficacy in the treatment of postmenopausal @entity1 with @entity0 . Other agents that may be used in the sequence include a steroidal @entity11163 or a progestin. Furthermore, estrogen additive therapy by with diethylstilbestrol or ethinylestradiol has recently been revived and showed a high response rate as a salvage endocrine therapy, although its mechanism of action is still unclear. Thus, sequential use of endocrine therapies, especially the use of a subsequent therapy with a different mechanism of action to the prior therapy, has a beneficial effect in maintaining a good quality of life and extending survival for @entity0 with hormone responsiveness.
