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Summary of aromatase inhibitor clinical trials in postmenopausal women with early breast cancer.

Abstract
Five years of adjuvant therapy with tamoxifen was considered the gold-standard treatment for postmenopausal women with estrogen receptor-positive breast cancer for many years. Data from a core group of clinical trials investigating the safety and efficacy of aromatase inhibitors (AIs) have challenged this perception. These studies were designed to evaluate the safety and efficacy of AIs in the following clinical settings: 1) as initial adjuvant therapy (the Arimidex, Tamoxifen, Alone or in Combination trial, Breast International Group Trial 1-98), 2) in a "switched setting" after 2 to 3 years of treatment with tamoxifen (Arimidex-Nolvadex 95, the Austrian Breast and Colorectal Cancer Study Group 8 [ABCSG 8] trial, the Italian Tamoxifen Anastrozole study, the Intergroup Exemestane Study), and 3) in extended settings (National Cancer Institute of Canada Trial MA.17, ABCSG 6a, National Surgical Adjuvant Breast and Bowel Project 33). The efficacy data from these studies suggested that AIs have added substantial benefit in terms of disease outcome. AIs were tolerated well, and patients who received them experienced fewer thrombolic events and less endometrial cancer, hot flashes, night sweats, and vaginal bleeding compared with patients who receive tamoxifen. However, patients who received tamoxifen had less skeletal events and accelerated bone resorption compared with women who received AIs. AIs should be considered when planning a patient's endocrine therapy, taking into account the differences in tolerability and end-organ effects of the classes of endocrine therapy. Outstanding issues to optimize AI therapy include identifying the optimal duration, agent, and patients for these therapies.
AuthorsAman U Buzdar, R Charles Coombes, Paul E Goss, Eric P Winer
JournalCancer (Cancer) Vol. 112 Issue 3 Suppl Pg. 700-709 (Feb 01 2008) ISSN: 0008-543X [Print] United States
PMID18072256 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
CopyrightCancer 2008. (c) 2007 American Cancer Society.
Chemical References
  • Aromatase Inhibitors
Topics
  • Aromatase Inhibitors (therapeutic use)
  • Breast Neoplasms (drug therapy, metabolism, pathology)
  • Clinical Trials as Topic
  • Female
  • Humans
  • Postmenopause

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