12-12-2009, 11:39 PM
@ waynerooney
whats ur say on this..waiting..
whats ur say on this..waiting..
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good question - march2011
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12-12-2009, 11:43 PM
aromatase inhibitors may improve survival and reduce breast cancer recurrence compared to tamoxifen in women with early estrogen-receptor-positive breast cancer (level 2 [mid-level] evidence)
based on systematic review with limited data for some drugs systematic review of trials comparing aromatase inhibitors (anastrozole, letrozole, exemestane) vs. tamoxifen for 5 years in women with early estrogen-receptor-positive breast cancer overall survival improved with anastrozole switching strategy based on meta-analysis of 3 trials no differences established with letrozole or exemastine disease-free survival shown to be improved with anastrozole as primary adjuvant therapy letrozole as primary adjuvant therapy exemastine switching strategy breast cancer recurrence shown to be reduced with anastrozole as primary adjuvant therapy letrozole as primary adjuvant therapy anastrozole switching strategy extended adjuvant anastrozole extended adjuvant letrozole Reference - Health Technol Assess 2007 Jul;11(26):1 full-text aromatase inhibitors may have survival benefit over other endocrine therapies in postmenopausal women with advanced breast cancer (level 2 [mid-level] evidence) based on Cochrane review with heterogeneity and inadequate reporting of trial quality systematic review of 37 randomized trials evaluating aromatase inhibitors in 14,060 postmenopausal women with advanced (metastatic) breast cancer comparing aromatase inhibitors vs. other endocrine therapy (except for overall survival, all results limited by significant heterogeneity [p ≤ 0.02]) no significant difference in progression-free survival in analysis of 11 trials with 5,890 women aromatase inhibitors associated with improved overall survival (hazard ratio 0.9, 95% CI 0.84-0.97) in overall analysis of 13 trials with 4,789 women no significant differences in 5 of 6 subgroup analyses by individual aromatase inhibitor exemestane associated with significant improvement in overall survival in 1 trial similar result reported in subgroup analysis limited to current aromatase inhibitors (anastrozole, exemestane and letrozole) increased rate of clinical benefit (odds ratio [OR] 0.87, 94% CI 0.77-0.99) in analysis of 27 trials with 8,789 women non-significant trend toward increased rates of objective response (OR 0.88, 95% CI 0.77-1.01) in analysis of 31 trials with 9,595 women limited direct evidence comparing aromatase inhibitors suggests letrozole may be more effective than anastrozole Reference - Cochrane Database Syst Rev 2009 Oct 7;(4):CD003370 I am not able to access the guidelines from NCCN the authority which oversees cancer rx in US.......but wud pretty much be the same as it is based on the same evidence and this was updated Oct this year.......
12-12-2009, 11:59 PM
@km2
just accessed NCCN breast cancer guidelines version 1 for 2010........ concur with exactly the same thing as above...... @drpanchet............raloxifene has been shown to be efficacious in few new trials and wud become mainstream rx soon i think but the experience and efficacy observed with tamoxifen wud have to be replicated till it becomes firstline...... btw.......raloxifene is neutral for endometrial tissue not an antagonist........ goodnite guys!
12-13-2009, 06:11 AM
wow .. very good discussion.. Thanks to everyone......
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