The Pharmaceutical Journal
Vol 280 No 7493 p301
15 March 2008

This article
Reprint   Photocopy

  Acrobat Reader

News summary

Study supports use of aromatase inhibitors after tamoxifen use ends

Women who finished tamoxifen treatment for breast cancer several years ago may still benefit from taking letrozole to reduce their risk of recurrence further, according to the lead researcher of an international study.

Paul Goss, Massachusetts General Hospital cancer centre, Boston, and colleagues conducted a multicentre phase III trial to examine the efficacy of letrozole started after adjuvant tamoxifen in postmenopausal women with hormone receptor-positive early-stage breast cancer.

They found that, compared with placebo, letrozole reduced the risk of breast cancer recurrence by 63 per cent (hazard ratio 0.37, 95 per cent confidence interval 0.23–0.61; P<0.0001) and the risk of cancer spread by 61 per cent (0.39, CI 0.20–0.74; P<0.004) in women who had completed five years of tamoxifen therapy one to seven years earlier.

The researchers note that there were more self-reported cases of osteoporosis and more clinical fractures in the women who were treated with letrozole. The study is published online ahead of appearing in the April 2008 issue of the Journal of Clinical Oncology.

In a separate analysis of the same trial (ibid), researchers led by Hyman Muss, professor of medicine at the University of Vermont, Burlington, conclude that the reduced risk of breast cancer recurrence persisted among all age groups, including women over 70 years, although was only statistically significant for disease-free survival in women under 60 years.