Fulvestrant can therefore be considered as alternative therapy to anastrozole or exemestane in postmenopausal women with locally advanced or metastatic breast cancer that has recurred on prior adjuvant endocrine therapy or progressed on prior endocrine therapy for advanced disease .
A systematic review was undertaken to examine all available evidence to develop and support clinical recommendations regarding the use of fulvestrant ( Faslodex ® ) as systemic therapy of locally advanced or metastatic breast cancer in postmenopausal women .
Phase III study of letrozole versus tamoxifen as first-line therapy of advanced breast cancer in postmenopausal women: analysis of survival and update of efficacy from the International Letrozole Breast Cancer Group.
PURPOSE To analyze overall survival ( OS ) and up date efficacy data for letrozole versus tamoxifen as first-line therapy in postmenopausal women with locally advanced or metastatic breast cancer . PATIENTS AND METHODS This multicenter phase III trial r and omly assigned 916 patients with hormone receptor-positive or unknown tumors  letrozole 2.5 mg ( n = 458 ) or tamoxifen 20 mg ( n = 458 ) daily until disease progression . Optional cross-over was permitted at the treating physician 's discretion . This report up date s efficacy at a median follow-up of 32 months . RESULTS The superiority of letrozole to tamoxifen was confirmed for time to progression ( median , 9.4 v 6.0 months , respectively ; P < .0001 ) , time to treatment failure ( median , 9 v 5.7 months , respectively ; P < .0001 ) , overall objective response rate ( 32 % v 21 % , respectively ; P = .0002 ) , and overall clinical benefit . Median OS was slightly prolonged for the r and omized letrozole arm ( 34 v 30 months , respectively ) . Although this difference in OS is not significant , survival was improved in the r and omized letrozole arm over the first 2 years of the study . Approximately one half of the patients in each arm crossed over . Total duration of endocrine therapy ( " time to chemotherapy " ) was significantly longer ( P = .005 ) for patients initially on letrozole ( median , 16 months ) than for patients initially on tamoxifen ( median , 9 months ) . Time to worsening of Karnofsky performance score was significantly delayed with letrozole compared with tamoxifen ( P = .001 ) . CONCLUSION This study documents the superiority of letrozole over tamoxifen in first-line endocrine therapy in postmenopausal women with advanced breast cancer
Fulvestrant can therefore be considered as alternative therapy to anastrozole or exemestane in postmenopausal women with locally advanced or metastatic breast cancer that has recurred on prior adjuvant endocrine therapy or progressed on prior endocrine therapy for advanced disease .
A systematic review was undertaken to examine all available evidence to develop and support clinical recommendations regarding the use of fulvestrant ( Faslodex ® ) as systemic therapy of locally advanced or metastatic breast cancer in postmenopausal women .