Extended adjuvant endocrine therapy in hormone-receptor positive breast cancer.
A high ongoing recurrence rate in patients with endocrine responsive breast cancer provides the rationale for offering endocrine treatment for more than five years. The MA.17 study, comparing the aromatase inhibitor (AI) letrozole for five years after an initial five years of tamoxifen to no further treatment, provided the proof-of-principle for extended endocrine treatment. These results have meanwhile been confirmed by several other studies and an EBCTCG meta-analysis. More recently, data from the ATLAS trial, comparing 10 to five years of tamoxifen, have been published, similarly showing a benefit for longer endocrine treatment with tamoxifen. In postmenopausal women -including those who had been premenopausal at initial diagnosis - a cross-trial comparison of ATLAS and the AI studies indicates superiority of switching to letrozole versus ongoing tamoxifen, similar to superiority of the AIs over tamoxifen in the metastatic and early breast cancer settings.
Center for Oncology, Hematology and Palliative Care, Wilhelminen Hospital, Montleartstr. 36, A-1160 Vienna, Austria. Electronic address: Kathrin.strasserweippl@gmail.com.
Kathrin
K
Strasser-Weippl
Tanja
T
Badovinac-Crnjevic
Lei
L
Fan
Paul E
PE
Goss
D000328:Adult; D000368:Aged; D018931:Antineoplastic Agents, Hormonal / Q000008:administration & dosage* / Q000009:adverse effects; D047072:Aromatase Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects; D014408:Biomarkers, Tumor / Q000032:analysis / Q000378:metabolism*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000378:metabolism / Q000401:mortality / Q000473:pathology; D017024:Chemotherapy, Adjuvant; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D000077289:Letrozole; D008134:Long-Term Care; D015412:Mastectomy, Segmental / Q000379:methods / Q000401:mortality; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D009376:Neoplasms, Hormone-Dependent / Q000188:drug therapy / Q000401:mortality / Q000473:pathology; D009570:Nitriles / Q000008:administration & dosage / Q000009:adverse effects; D017698:Postmenopause / Q000187:drug effects / Q000502:physiology; D017697:Premenopause / Q000187:drug effects / Q000502:physiology; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D016019:Survival Analysis; D013629:Tamoxifen / Q000008:administration & dosage / Q000009:adverse effects; D016896:Treatment Outcome; D014230:Triazoles / Q000008:administration & dosage / Q000009:adverse effects
D018931:Antineoplastic Agents, Hormonal; D047072:Aromatase Inhibitors; D014408:Biomarkers, Tumor; D009570:Nitriles; D014230:Triazoles; D013629:Tamoxifen; D000077289:Letrozole
Adjuvant; Breast cancer; Endocrine; Extended treatment