[Efficacy and safety of high-dose toremifene for hormone-responsive advanced or metastatic breast cancer patients with failed prior treatment by aromatase inhibitors].
BACKGROUND
Recently, aromatase inhibitors (AI) are widely used in postoperative adjuvant therapy for breast cancer. Nevertheless, studies of postoperative therapeutic strategies for recurrent breast cancer are insufficient.


METHODS
Data on 12 post-menopausal advanced/recurrent breast cancer patients in our department during June 2003- April 2007 were used for this study. No patient had responded to high-dose toremifene (TOR), a third-generation AI. Their therapeutic outcomes were analyzed retrospectively. The median observation period of the subjects was 16.1 months (4.0-40.9 months). Subjects were all hormone-sensitive. Overexpression of HER2 protein was found in only one case. During AI therapy immediately prior, exemestane (EXE) and anastrozole (ANA) had been given in nine and three cases, respectively.


RESULTS
The complete response rate of AI therapy was 16.7% (2/12). The clinical benefit rate was 58.3% (7/12). The median of time to progression (TTP) was 33.8 weeks. Neither the presence nor absence of past history of treatment with tamoxifen (TAM) or other chemotherapies affected the anti-tumor effect. Analysis by the site of metastasis or recurrence revealed that the therapeutic effects were better for non-life-threatening cases in the lung, pleura, soft tissue, etc. The severities of adverse effects were all less than grade 2; the major ones were flushing and sweating.


CONCLUSIONS
Results show that high-dose TOR given at an early stage can provide clinical benefits for post-menopausal advanced/recurrent breast cancer not responding to AI.
Ohtake
Tohru
T
Dept. of Surgery, Fukushima Medical University School of Medicine.
Yasuda
Mitsuhiko
M
Watanabe
Kumiko
K
Ito
Taisuke
T
Ito
Jun
J
Miyamoto
Kotaro
K
Yoshida
Sayaka
S
Abe
Noriko
N
Ishigame
Teruhide
T
Ishii
Maiko
M
Kimijima
Izo
I
Takenoshita
Seiichi
S
D000368:Aged; D018931:Antineoplastic Agents, Hormonal / Q000008:administration & dosage* / Q000009:adverse effects; D047072:Aromatase Inhibitors / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy*; D019008:Drug Resistance, Neoplasm; D005260:Female; D006801:Humans; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009376:Neoplasms, Hormone-Dependent / Q000188:drug therapy*; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000032:analysis; D017312:Toremifene / Q000008:administration & dosage* / Q000009:adverse effects
D018931:Antineoplastic Agents, Hormonal; D047072:Aromatase Inhibitors; D018719:Erb-b2 Receptor Tyrosine Kinases; D017312:Toremifene