Sequential Treatment with Exemestane and Non-Steroidal Aromatase Inhibitors in Advanced Breast Cancer

Oncology ◽  
2005 ◽  
Vol 69 (6) ◽  
pp. 471-477 ◽  
Author(s):  
Gianfilippo Bertelli ◽  
Ornella Garrone ◽  
Marco Merlano ◽  
Marcella Occelli ◽  
Laura Bertolotti ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Advanced Breast Cancer ◽  
Aromatase Inhibitors ◽  
Advanced Breast ◽  
Sequential Treatment ◽  
Steroidal Aromatase Inhibitors

Role of aromatase inhibitors in advanced breast cancer.

1999 ◽  
pp. 219-225 ◽  
Author(s):  
A U Buzdar
Keyword(s):  
Breast Cancer ◽  
Advanced Breast Cancer ◽  
Postmenopausal Women ◽  
Aromatase Inhibitors ◽  
Advanced Breast ◽  
Cross Resistance ◽  
Full Potential ◽  
Large Program ◽  
Steroidal Aromatase Inhibitors ◽  
New Generation

A number of potent and selective non-steroidal aromatase inhibitors are now available for treatment of advanced breast cancer in postmenopausal women, of which anastrozole and letrozole, in particular, represent a significant advantage over the earlier agents in terms of both efficacy and tolerability. These agents are rapidly becoming established as the second-line therapy of choice in postmenopausal women with advanced disease, progressing on tamoxifen, and data on their efficacy as first-line treatment compared with tamoxifen will be available in the near future. Exemestane, a new, steroidal aromatase inhibitor which potentially lacks cross-resistance with non-steroidal agents is still in clinical development. The full potential of the new-generation aromatase inhibitors in the treatment of breast cancer is currently being investigated in a large program of clinical trials evaluating their use as adjuvant treatment following surgery in postmenopausal patients with early disease.

Fulvestrant in heavily pre-treated breast cancer patients—Single institution experience

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 13157-13157
Author(s):  
J. H. Schornagel ◽  
H. H. Helgason ◽  
S. Rodenhuis ◽  
J. H. Schellens
Keyword(s):  
Breast Cancer ◽  
Advanced Breast Cancer ◽  
Aromatase Inhibitors ◽  
Hormonal Treatment ◽  
Advanced Breast ◽  
Breast Cancer Patients ◽  
Treated Breast ◽  
Steroidal Aromatase Inhibitors ◽  
Treated Breast Cancer ◽  
Hormonal Treatments

13157 Background: Fulvestrant is a selective estrogen and progesterone receptor down regulator with equivalent efficacy, i.e. RR, TTP and OS, in comparison to anastrozole in the 1st and 2nd line of hormonal treatment in women with advanced breast cancer. Methods: We retrospectively evaluated all patients with advanced breast cancer who were treated with fulvestrant between 06/2003 and 08/2005 in our institution. Response was evaluated according to the RECIST criteria in case of measurable disease but with bone scintigraphy (new bone metastasis) and/or change in CA 15.3 in case of evaluable disease. Results: In total 32 patients (20 with measurable and 12 with evaluable disease) with advanced breast cancer were identified. Median age was 50 (range: 24 - 72) years, 25 (78%) patients had bone/soft tissue involvement, 17 (53%) had visceral metastases and 1 had CNS metastases. All had received prior hormonal treatments; fulvestrant was the 3rd, 4th or higher line of hormonal treatment in 26 (81%) and 20 (63%) patients, respectively. The preceding hormonal treatments mostly included tamoxifen, non-steroidal aromatase inhibitors, steroidal aromatase inhibitors and megestrole acetate, but also ovarian ablation and aminoglutethimide. In total 20 (63%) patients had received prior adjuvant or palliative chemotherapy, 13 (41%) had received 2≥ and 5 patients (16%) had received 4≥ lines of chemotherapy. The chemotherapy contained an anthracycline, a taxane or capecitabine, but also vinorelbine, gemcitabine or high dose chemotherapy. In total 139 administrations of fulvestrant (mean: 4.3; range 1 - 18) were given. Most patients received 3 - 6 administrations except two who received 17 and 18 administrations respectively. In this cohort of 32 patients no objective tumor response or clinical benefit was seen, except in 1 patient, previously treated with tamoxifen, who had stable disease for > 18 months. The patient receiving fulvestrant for 17 months was slowly progressive during treatment. Fulvestrant was well tolerated without treatment discontinuation because of toxicity. Conclusion: Fulvestrant was not effective in our small cohort of heavily pre-treated breast cancer patients and may not be a good treatment option after 3rd or higher line of hormonal treatment or chemotherapy. No significant financial relationships to disclose.

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