Meta-analyses of phase 3 randomised controlled trials of third generation aromatase inhibitors versus tamoxifen as first-line endocrine therapy in postmenopausal women with hormone receptor-positive advanced breast cancer
نویسندگان
چکیده
BackgroundFour randomised controlled trials (RCTs) in postmenopausal women with advanced breast cancer (ABC) comparing aromatase inhibitors (AIs) versus the selective estrogen receptor modulator tamoxifen, each individually reported significantly longer progression-free survival (PFS) but none showed a significant difference overall (OS). In these between 6.8% and 55% of tumours were hormone (HR) status unknown or negative. This meta-analysis restricted comparison to HR-positive (HR+) tumours.MethodsAnonymised individual patient data obtained from three RCTs, EORTC (exemestane tamoxifen), Study 0027 0030 (both anastrozole tamoxifen). For remaining RCT (Femara PO25; letrozole odds ratio (OR) hazard (HzR), confidence intervals clinical study report, for patients HR+ tumours, addition published data. total, 2296 patients; 1560 (68%) had ABC.FindingsThe OR benefit rate was 1.56, favour AIs (p < 0.001). The duration not increased by (HzR 0·88; p = 0.08). PFS HzR (0.82) 0·007). However, OS (1.05) different tamoxifen 0.42).InterpretationAlthough third generation put more into ‘clinical benefit’, their longer. Overall, while this resulted greater AIs, did translate improvement OS.
منابع مشابه
Aromatase inhibitors versus tamoxifen in early breast cancer: patient-level meta-analysis of the randomised trials
BACKGROUND The optimal ways of using aromatase inhibitors or tamoxifen as endocrine treatment for early breast cancer remains uncertain. METHODS We undertook meta-analyses of individual data on 31,920 postmenopausal women with oestrogen-receptor-positive early breast cancer in the randomised trials of 5 years of aromatase inhibitor versus 5 years of tamoxifen; of 5 years of aromatase inhibito...
متن کاملAromatase inhibitors versus tamoxifen in early breast cancer: patient-level meta-analysis of the randomised trials
Methods We undertook meta-analyses of individual data on 31 920 postmenopausal women with oestrogen-receptorpositive early breast cancer in the randomised trials of 5 years of aromatase inhibitor versus 5 years of tamoxifen; of 5 years of aromatase inhibitor versus 2–3 years of tamoxifen then aromatase inhibitor to year 5; and of 2–3 years of tamoxifen then aromatase inhibitor to year 5 versus ...
متن کاملAnastrozole is superior to tamoxifen as first-line therapy in hormone receptor positive advanced breast carcinoma.
BACKGROUND Two randomized, double-blind trials have compared tamoxifen 20 mg daily and the selective, nonsteroidal aromatase inhibitor anastrozole 1 mg daily as first-line therapy for advanced breast carcinoma (ABC) in postmenopausal women. The trials were prospectively designed to allow for combined data analyses. METHODS The combined study population included 1021 postmenopausal women (medi...
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متن کاملReview of hormone-based treatments in postmenopausal patients with advanced breast cancer focusing on aromatase inhibitors and fulvestrant
BACKGROUND Endocrine therapy constitutes a central modality in the treatment of oestrogen receptor (ER)-positive advanced breast cancer. PURPOSE To evaluate the evidence for endocrine treatment in postmenopausal patients with advanced breast cancer focusing on the aromatase inhibitors, letrozole, anastrozole, exemestane and fulvestrant. METHODS A review was carried out using PubMed. Randomi...
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ژورنال
عنوان ژورنال: European Journal of Cancer
سال: 2021
ISSN: ['0959-8049', '1879-0852']
DOI: https://doi.org/10.1016/j.ejca.2020.11.038