The Pharmaceutical Journal
Vol 277 No 7428 p626
25 November 2006

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NICE approves treatment with aromatase inhibitors for women with early breast cancer

The aromatase inhibitors — anastrozole, exemestane and letrozole — have been recommended by the National Institute for Health and Clinical Excellence for the adjuvant treatment of early oestrogen-receptor-positive invasive breast cancer in postmenopausal women.

NICE’s recommendations relate to the drugs’ licensed indications at the time of the appraisal. These were: anastrozole for primary adjuvant therapy; exemestane for adjuvant therapy following two to three years of adjuvant tamoxifen therapy; and letrozole for primary adjuvant therapy and extended adjuvant therapy following standard tamoxifen therapy. The guidance specifies that the choice of treatment should be made after discussion with the patient, with consideration to whether the woman has received tamoxifen before, the licensed indications and side effect profiles of the drugs, and the risk of recurrence of breast cancer.

Since the appraisal, anastrozole has been granted an extension to its licence to include adjuvant therapy following two to three years of adjuvant tamoxifen. NICE was unable to make specific recommendations for anastrozole for this indication.