Tamoxifen-aromatase inhibitor combo improves Ca outcomes.(News)

SAN ANTONIO -- Switching postmenopausal breast cancer patients to an aromatase inhibitor following 2-3 years of adjuvant tamoxifen results in markedly better disease-free survival than the traditional 5 full years of tamoxifen, according to three major randomized trials presented at a breast cancer symposium sponsored by the Cancer Therapy and Research Center.

Raimund Jakesz, M.D., recommended that breast cancer patients who fit the profile of participants in two European clinical trials he reported on at the conference be routinely switched to 3 years of anastrozole (Arimidex) after 2 years of tamoxifen.

He reported on more than 3,100 breast cancer patients in the AstraZeneca-sponsored Austrian Breast and Colo rectal Cancer Study Group Trial 8 and the German Adjuvant Breast Cancer Group ARNO 95 study who were randomized to 5 years of adjuvant tamoxifen or to 2 years of tamoxifen followed by 3 years of anastrozole.

The 3-year rate of freedom from locoregional recurrence, distant metastasis, and contralateral breast cancer was 95.8% in the tamoxifen/anastrozole group, compared with 92.7% in the tamoxifen arm. The likelihood of survival free of distant recurrence was 39% greater with tamoxifen followed by anastrozole, said Dr. Jakesz, professor of surgery at the University of Vienna.

All participants in the two randomized trials were postmenopausal, had hormone receptor-positive disease, and underwent breast-conserving therapy. One-quarter were node positive. None received chemotherapy. Forty percent were under 60 years old. Most patients had small, well-differentiated tumors.

In a separate presentation, Charles Coombes, M.D., presented an update on the Intergroup Exemestane Study (IES), in which 4,740 postmenopausal breast cancer patients were randomized to 5 years of adjuvant tamoxifen or switched to exemestane (Aromasin) after 2-3 years. At a median 37 months of follow-up, local or distant ...