Switch to aromatase inhibitor improves survival
Cancer cells: recurrence is reduced |
Replacing tamoxifen with anastrozole (Arimidex) improves survival of patients with early breast cancer compared with continuing on tamoxifen for five years, according to results from the first study to show a survival benefit of changing hormonal therapy.
The meta-analysis of three trials with
similar design included 4,006 women with hormone-sensitive early breast
cancer who were randomised to switch to anastrozole after two to three
years of tamoxifen or to remain on tamoxifen for five years.
The results showed that women changing to anastrozole gained a 29 per
cent improvement in survival compared with those remaining on tamoxifen
(hazard ratio 0.71, 95 per cent confidence interval 0.52-0.98; P=0.0377).
The risk of disease recurrence was reduced by 45 per cent and risk of
distant recurrence fell by 39 per cent.
Reporting the findings at the San Antonio
breast cancer symposium last
week, Walter Jonat, of University of Kiel, Germany, said: “Results
from a previous study — the ATAC trial — showed that survival
is improved if patients start treatment with an aromatase inhibitor rather
than tamoxifen. This meta-analysis shows that survival is also increased
if patients already on tamoxifen are switched to anastrozole.”
Geoff Saunders, Macmillan cancer network pharmacist for Greater Manchester
and Cheshire, commented: “These findings are encouraging us towards
using aromatase inhibitors at an earlier stage in the treatment of breast
cancer. The evidence indicates that we should start women with oestrogen
receptor-positive early breast cancer with an aromatase inhibitor at
diagnosis. Those already on tamoxifen should be switched early, rather
than remaining on tamoxifen for five years.” |
The
Pharmaceutical Journal
Acrobat
Reader