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 .
Exemestane is superior to megestrol acetate after tamoxifen failure in postmenopausal women with advanced breast cancer: results of a phase III randomized double-blind trial. The Exemestane Study Group.
PURPOSE This phase III , double-blind , r and omized , multicenter study evaluated the efficacy , pharmacodynamics , and safety of the oral aromatase inactivator exemestane ( EXE ) versus megestrol acetate ( MA ) in postmenopausal women with progressive advanced breast cancer who experienced failure of tamoxifen . PATIENTS AND METHODS A total of 769 patients were r and omized to EXE  25 mg/d ( n = 366 ) or MA ( n = 403 ) 40 mg four times daily . Tumor response , duration of tumor control , tumor-related signs and symptoms ( TRSS ) , quality of life ( QOL ) , survival , and tolerability were evaluated . RESULTS Overall objective response ( OR ) rates were higher in patients treated with EXE than in those treated with MA ( 15.0 % v 12.4 % ) ; a similar trend was noted in patients with visceral metastases ( 13.5 % v 10.5 % ) . Median survival time was significantly longer with EXE ( median not reached ) than with MA ( 123.4 weeks ; P = .039 ) , as were the median duration of overall success ( OR or stable disease > or = 24 weeks ; 60.1 v 49.1 weeks ; P = .025 ) , time to tumor progression ( 20.3 v 16.6 weeks ; P = .037 ) , and time to treatment failure ( 16.3 v 15.7 weeks ; P = .042 ) . Compared with MA , there were similar or greater improvements in pain , TRSS , and QOL with EXE . Both drugs were well tolerated . Grade 3 or 4 weight changes were more common with MA ( 17.1 % v 7.6 % ; P = .001 ) . CONCLUSION EXE prolongs survival time , time to tumor progression , and time to treatment failure compared with MA and offers a well-tolerated treatment option for postmenopausal women with progressive advanced breast cancer who experienced failure of tamoxifen
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 .