Fulvestrant ('Faslodex')--a new hormonal treatment for advanced breast cancer

In patients with hormone receptor-positive advanced breast cancer (ABC), endocrine therapy is as effective as cytotoxic chemotherapy but is better tolerated. Most breast cancers are hormone responsive, but eventually develop resistance to individual endocrine agents. However, changing to a different type of endocrine therapy when resistance develops can circumvent this problem and delay the need for cytotoxic chemotherapy. Such chemotherapy can have a major impact on patient's quality of life, and for this reason is generally considered to be a last option for breast cancer patients. Fulvestrant ('Faslodex') is a new type of endocrine therapy with a different mode of action to existing treatments. It is at least as effective as the third-generation aromatase inhibitor (AI) anastrozole or letrozole in the treatment of postmenopausal women with advanced, tamoxifen-resistant breast cancer. Fulvestrant also appears to be effective after treatment with non-steroidal AIs. Fulvestrant is well tolerated and provides a further option in the endocrine treatment of ABC.