Letrozole reduces breast cancer recurrence rates
Compared with tamoxifen, letrozole (Femara; Novartis) significantly reduces the risk of recurrence of hormone-receptor-positive breast cancer in post-menopausal women, new data have shown (New England Journal
of Medicine 2005:26:2747).
The study of 8,010 women compared four treatment groups: five years of
treatment with letrozole; five years of tamoxifen; two years of letrozole
followed by three years of tamoxifen; and two years of tamoxifen followed
by three years of letrozole.
At 25.8 months of follow-up, women given letrozole monotherapy or initial
letrozole treatment showed increased disease-free survival (hazard ratio
for recurrence, contralateral cancer or death 0.81, 95 per cent confidence
interval 0.70–0.93; P=0.003) and reduced recurrence at distant
sites (hazard ratio 0.73, 0.60–0.88).
Although fractures were more frequent with letrozole monotherapy or initial
treatment (5.7 per cent vs 4.0 per cent, P<0.001), these regimens
were associated with fewer thromboembolic events (1.5 per cent vs 3.5
per cent), a lower rate of vaginal bleeding (3.3 per cent vs 6.6 per
cent) and fewer endometrial biopsies (2.3 per cent vs 9.1 per cent, all
P<0.001). In order to determine whether letrozole will continue to
reduce the risk of relapse for several years after the cessation of treatment,
longer follow-up studies will be needed, the authors state. |
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