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Preliminary data from ongoing adjuvant aromatase inhibitor trials.

P E Goss1

  • 1Princess Margaret Hospital, Toronto, Ontario, Canada. pegoss@interlog.com

Clinical Cancer Research : an Official Journal of the American Association for Cancer Research
|March 28, 2002
PubMed
Summary

Aromatase inhibitors like letrozole and anastrozole show promise in adjuvant therapy for postmenopausal breast cancer. Ongoing trials are evaluating their use after tamoxifen or in sequence to improve patient outcomes.

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Area of Science:

  • Oncology
  • Endocrinology
  • Clinical Trials

Background:

  • Recent data indicate letrozole and anastrozole are more effective than tamoxifen for advanced breast cancer.
  • Aromatase inhibitors are being investigated for adjuvant therapy in postmenopausal, receptor-positive breast cancer.
  • Established tamoxifen therapy is being compared against novel aromatase inhibitor regimens.

Purpose of the Study:

  • To review the rationale, design, and preliminary results of ongoing adjuvant trials involving aromatase inhibitors.
  • To assess the efficacy of aromatase inhibitors in postmenopausal breast cancer adjuvant settings.
  • To explore different strategies for integrating aromatase inhibitors into breast cancer treatment protocols.

Main Methods:

  • Review of ongoing international adjuvant clinical trials (e.g., MA.17, NSABP B33, ICCG, ARNO, BIG/FEMTA, ATAC).

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  • Evaluation of two main strategies: aromatase inhibitors after tamoxifen, and sequential use of tamoxifen and aromatase inhibitors.
  • Inclusion of trials comparing aromatase inhibitors as a replacement for, or in combination with, tamoxifen.

    • Main Results:

    • Preliminary results suggest aromatase inhibitors are superior to tamoxifen in advanced disease.
    • Multiple trials are underway evaluating letrozole, anastrozole, and exemestane in various adjuvant settings.
    • Companion studies are investigating the effects of aromatase inhibitors on non-breast end-organs.

    Conclusions:

    • Aromatase inhibitors are expected to significantly impact the treatment paradigm for breast cancer.
    • These agents hold potential for improving outcomes in a substantial number of postmenopausal patients.
    • Further results from ongoing adjuvant trials are anticipated to solidify the role of aromatase inhibitors.