Aromasin ®
Improves Responses Compared to Nolvadex ® as Initial Treatment
in Advanced Breast Cancer
According to a recent article published in the Annals of Oncology,
Aromasin ® (exemestane) appears superior to Nolvadex ®
(tamoxifen) as initial hormonal therapy for metastatic breast
cancer.
Breast cancer claims the lives of approximately 40,000 women
every year in the United States alone. Early-stage breast
cancer in which the cancer has not spread from its site of
origin has a high cure rate with standard therapy. However,
once the cancer has spread to several and/or distant sites
in the body and is considered to be at an advanced stage,
cure rates fall dramatically. Researchers are continuing to
develop and evaluate novel agents in order to improve survival
for patients with advanced breast cancer.
A common type of breast cancer is referred to as hormone-positive
breast cancer. Hormone-positive breast cancer is stimulated
to grow by the circulating female hormones estrogen and/or
progesterone. Hormonal therapy is a type of therapy used for
hormone-positive breast cancer that reduces or prevents the
growth-stimulatory effects of estrogen and/or progesterone
on cancer cells. Nolvadex ® (tamoxifen) has been the historical
standard agent used for hormonal therapy in breast cancer;
however, newer agents referred to as aromatase agents have
entered the clinical arena as hormonal agents for treatment
of breast cancer. Aromatase agents inhibit the action of the
enzyme aromatase, which is involved in the conversion of pre-cursors
to the final form of estrogen in the body. Aromatase agents
are approved for various stages of breast cancer and clinical
trials are ongoing to evaluate their timing in the treatment
of hormone-positive breast cancer. Aromasin ® is the only
agent currently approved that irreversibly binds to aromatase
and is approved for advanced breast cancer in postmenopausal
women that has stopped responding to treatment with Nolvadex ®.
Researchers from the European Organization for Research and
Treatment of Cancer (EORTC) recently conducted a clinical
trial to evaluate Aromasin ® as initial therapy for advanced
breast cancer. This trial involved 122 patients with hormone-positive
breast cancer that were treated initially with either Aromasin ®
or Nolvadex ®. Patients treated with Aromasin ® had
an anti-cancer response rate of 41%, approximately 3 times
greater than those treated with Nolvadex ® (17%). Treatment
was well-tolerated, with approximately equal or fewer incidences
of shortness of breast, swelling, fatigue, hot flashes and
bone pain for those treated with Aromasin ®, compared to
Nolvadex ®.
The researchers concluded that Aromasin ® appears superior
to Nolvadex ® as initial hormone therapy in postmenopausal
women diagnosed with advanced, hormone-positive breast cancer.
Longer follow-up is necessary to determine if these results
will confer a survival benefit. These results have prompted
the initiation of a larger trial to confirm these results.
In addition, Aromasin ® is being evaluated as treatment
for earlier stage, hormone-positive breast cancers as well
as the prevention of breast cancer. Patients with advanced,
hormone-positive breast cancer may wish to speak with their
physician about the risks and benefits of treatment with Aromasin ®
or the participation in a clinical trial further evaluating
aromatase agents or other novel therapeutic approaches. Two
sources of information regarding ongoing clinical trials include
the National Cancer Institute ( cancer.gov) and www.cancerconsultants.com.
Personalized clinical trial searches are also performed on
behalf of patients at www.cancerconsultants.com.
Reference: Paridaens L, Dirix C, Lohrisch L, et al. Mature
results of a randomized phase II multicenter study of exemestane
versus tamoxifen as first-line hormone therapy for postmenopausal
women with metastatic breast cancer. Annals of Oncology. 2003;14:1391-1398.
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