Tuesday, July 13, 2010 (Last Updated: 07/16/2010)
TUESDAY, July 13 (HealthDay News) -- An aromatase inhibitor (AI) should be included in adjuvant endocrine therapy for postmenopausal women with hormone receptor-positive breast cancer, according to updated American Society of Clinical Oncology guidelines published online July 12 in the Journal of Clinical Oncology.
Harold J. Burstein, M.D., of the Dana-Farber Cancer Institute in Boston, and colleagues conducted a systematic review of the literature on adjuvant endocrine therapy for postmenopausal women with hormone receptor-positive breast cancer. The outcomes of interest included disease-free survival, overall survival, and time to appearance of breast cancer in the contralateral breast.
The researchers found that several adjuvant strategies reduced the risk of recurrent breast cancer better than five years of tamoxifen alone. These included use of an AI alone as initial endocrine therapy; use of an AI sequentially with tamoxifen, in either order; and use of AI after five years of tamoxifen. Outcomes were similar with either AI monotherapy or AI used sequentially after tamoxifen for two to three years. The authors concluded that the data suggest choice of adjuvant endocrine therapy could be influenced by the different adverse event profiles of these treatments, and that the best timing and duration of endocrine therapies for postmenopausal women with breast cancer are currently unknown.
"Incorporation of an AI improves disease-free survival in postmenopausal women with hormone receptor-positive breast cancer compared with tamoxifen alone. Thus, the Update Committee recommends AI therapy at some point during adjuvant treatment, either as upfront therapy or as sequential or extended treatment after tamoxifen," the authors write.
Several of the authors disclosed financial relationships with pharmaceutical companies.
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