Aromatase inhibitors as adjuvant treatment of breast cancer.
The development of the novel, third-generation aromatase inhibitors and inactivators represents a major improvement of endocrine therapy in breast cancer. Subsequent to phase III studies revealing clinical superiority of these drugs compared to conventional therapy as second- and first-line treatment for advanced disease, several randomised studies have found these compounds, administered either as monotherapy or in sequence with tamoxifen, to improve relapse-free survival compared to tamoxifen monotherapy in the adjuvant setting. Notably, we lack data on long-term follow-up with respect to efficacy as well as side effects, and there are currently no data on head to head comparisons between the different aromatase inhibitors. Several critical issues, like influences of treatment on bone and blood lipid profiles underline the need for long-term follow-up with respect to clinical events like bone fractures and cardiovascular events. Finally, we need data on cost-utility with respect to the different strategies as well as with respect to patient age and risk profile.
Geisler
Jürgen
J
Section of Oncology, Institute of Medicine, University of Bergen, Haukeland University Hospital, N-5021 Bergen, Norway. jurgen.geisler@helse-bergen.no
Lønning
Per E
PE
D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D047072:Aromatase Inhibitors / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy*; D017024:Chemotherapy, Adjuvant / Q000379:methods; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D016032:Randomized Controlled Trials as Topic / Q000706:statistics & numerical data
D018931:Antineoplastic Agents, Hormonal; D047072:Aromatase Inhibitors