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 .
Sensitivity to further endocrine therapy is retained following progression on first-line fulvestrant
Summary There is a need for new endocrine agents that lack cross-resistance with currently available treatments to extend the endocrine treatment window and delay the need for cytotoxic chemotherapy . This retrospective analysis evaluated the response of postmenopausal patients with previously untreated metastatic/locally advanced breast cancer to further endocrine treatment following progression on first-line fulvestrant or tamoxifen .  Patients received fulvestrant 250 mg ( intramuscular injection every 28 days ) plus matching tamoxifen placebo ( once daily ) , or tamoxifen 20 mg ( orally once daily ) plus matching fulvestrant placebo ( every 28 days ) in a double-blind , r and omized , phase III trial . Treatment continued until disease progression or withdrawal , when further endocrine therapy was initiated ( at the treating physician ’s discretion ) . Information regarding subsequent therapies and responses was obtained by follow-up question naire . Two-hundred- and -forty-five question naires were returned ( from 587 patients ) , 149 of which yielded follow-up data on patients receiving second-line endocrine therapy following fulvestrant ( n=83 ) and tamoxifen ( n=66 ) . Second-line therapy produced objective responses ( OR ) in 6/44 ( 13.6 % ) and clinical benefit ( CB ) in 25/44 ( 56.8 % ) patients who had CB with fulvestrant and produced OR in 5/41 ( 12.2 % ) patients and CB in 27/41 ( 65.8 % ) patients who had CB with first-line tamoxifen . For patients deriving no CB from trial therapy , second-line therapy produced OR in 3/39 ( 7.7 % ) and CB in 15/39 ( 38.5 % ) patients in the fulvestrant group and OR in 4/25 ( 16.0 % ) and CB in 12/25 ( 48.0 % ) patients in the tamoxifen group . Results from this question naire-based study suggest that postmenopausal women with advanced breast cancer who respond to first-line fulvestrant or tamoxifen retain sensitivity to subsequent endocrine therapy
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 .