Switching from tamoxifen to aromatase inhibitors for adjuvant endocrine therapy in postmenopausal patients with early breast cancer

Cancer Treatment Reviews
C J H van de VeldeK I Pritchard

Abstract

The third-generation aromatase inhibitors (AIs), including anastrozole, exemestane and letrozole, have demonstrated improved efficacy versus tamoxifen for the adjuvant endocrine treatment of postmenopausal patients with hormone receptor-positive breast cancer. AIs can be used in several adjuvant endocrine settings: as upfront therapy, switch to an AI after 2-3years of tamoxifen or extended therapy following 5years of tamoxifen. In the switch setting, two different types of study designs have been utilized. One is a late randomization design which randomizes patients who are disease-free after 2-3years of tamoxifen to receive an AI versus continuation of tamoxifen. In contrast, an early randomization design randomizes all patients immediately after primary treatment and prior to starting tamoxifen. Efficacy benefits with AIs have been shown in several trials evaluating the late randomization strategy, including the Intergroup Exemestane Study, the Italian Tamoxifen Anastrozole trial and the Anastrozole-Nolvadex 95 trial. Similarly, early randomization studies, including the Austrian Breast and Colorectal Cancer Study Group-8 and the Breast International Group (BIG) 1-98 trial, have demonstrated the effectiveness of receiving an ...Continue Reading

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Citations

May 9, 2013·Nature Communications·Sagar GhoshRong Li
Jan 18, 2014·Endocrine-related Cancer·Kathleen Van AstenRobert Paridaens
Aug 9, 2011·Current Eye Research·Alvin Eisner, Shiuh-Wen Luoh
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Nov 29, 2014·International Journal of Cancer. Journal International Du Cancer·Rianne de GelderHarry J de Koning
Nov 5, 2014·Journal of Clinical Pharmacy and Therapeutics·E KellyA Vitry
Apr 28, 2020·American Journal of Epidemiology·Farzin Khosrow-KhavarLaurent Azoulay

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