| Transition
to anastrozole after two years of tamoxifen can improve event-free
survival for postmenopausal women with early breast cancer Use of anastrozole after two years of tamoxifen can improve event-free survival for postmenopausal women with early breast cancer, with events defined as local or distant recurrence or new cancer in the second breast, according to an article in the August 6th issue of The Lancet. For more than 20 years tamoxifen has been the standard treatment after surgery for postmenopausal women with hormone-responsive early breast cancer. However, research has shown that the aromatase inhibitor anastrozole is effective and tolerable in this group of patients compared with tamoxifen used as a first-line treatment. Studies have also suggested that taking anastrozole after two years of tamoxifen could be beneficial. Raimund Jakesz (Vienna Medical Universit, Vienna, Austria) and colleagues from the Austrian Breast and Colorectal Cancer Study Group and the German Adjuvant Breast Cancer Group combined data from two multicenter, randomized trials looking at the effect of taking anastrozole after tamoxifen. In both trials postmenopausal women who had received two years of tamoxifen treatment were randomized to anastrozole (1618 women) or tamoxifen (1606 women) for an additional three years. After two years of follow-up, there was a 40 percent decrease in the risk of an event for women in the anastrozole group compared with women in the tamoxifen group (67 events with anastrozole vs 110 with tamoxifen). More patients had bone fractures on anastrozole but there were fewer cases of blood clots than in the tamoxifen group. Professor Jakesz concluded, “Although further
investigation is necessary to ascertain the ideal sequence and duration
of adjuvant endocrine therapy, this combined analysis confirms that
post-menopausal women who receive tamoxifen as adjuvant therapy
should be switched to anastrozole after 2 years of treatment.” |