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Fulvestrant - a new treatment for postmenopausal women with hormone-sensitive advanced breast cancer

Kurt Possinger1

  • 1Universitätsmedizin, Department of Oncology and Haematology, Charité Campus Mitte, Berlin, Germany. kurt.possinger@charite.de

Expert Opinion on Pharmacotherapy
|December 2, 2004
PubMed

Insights

Fulvestrant, a novel endocrine therapy, effectively treats advanced hormone-sensitive breast cancer in postmenopausal women. It offers a new mechanism of action with comparable efficacy and improved tolerability versus existing treatments.

Area of Science:

  • Oncology
  • Endocrinology
  • Pharmacology

Background:

  • Estrogen receptor (ER) and progesterone receptor (PgR) positivity is common in postmenopausal breast cancer, indicating suitability for endocrine therapy.
  • Fulvestrant represents a novel class of ER antagonist with a unique mechanism of action, targeting ER degradation.

Purpose of the Study:

  • To evaluate the efficacy and tolerability of fulvestrant in postmenopausal women with advanced breast cancer.
  • To compare fulvestrant with anastrozole and tamoxifen in different treatment settings.

Main Methods:

  • Phase III clinical trials comparing fulvestrant to anastrozole in postmenopausal women with advanced breast cancer progressing on anti-estrogen therapy.
  • First-line treatment comparisons of fulvestrant and tamoxifen in ER-positive/PgR-positive disease.
  • Compassionate use program data for heavily pretreated patients.

Main Results:

  • Fulvestrant demonstrated comparable efficacy to anastrozole in terms of time to progression and objective response, with similar overall survival.
  • In the first-line setting, fulvestrant showed similar efficacy to tamoxifen for ER-positive/PgR-positive patients.
  • Fulvestrant was well tolerated, with a lower incidence of joint disorders than anastrozole and fewer hot flushes than tamoxifen.

Conclusions:

  • Fulvestrant is an effective and well-tolerated treatment option for hormone-sensitive advanced breast cancer in postmenopausal women.
  • Its novel mechanism offers a valuable alternative, potentially overcoming cross-resistance with other endocrine therapies.
  • Further trials are needed to establish its optimal role in the endocrine treatment sequence.

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