© 2006 European Society for Medical Oncology
symposium article |
Switching to anastrozole versus continued tamoxifen treatment of early breast cancer. Updated results of the Italian tamoxifen anastrozole (ITA) trial
1 The National Cancer Research Institute and the 2 University of Genoa, Genoa; 3 S. Orsola-Malpighi Hospital, Bologna; 4 Institute of Oncology, University of Messina, Messina; 5 San Donato Hospital, Arezzo; 6 S. Anna Hospital and University of Turin, Turin; 7 Institute of Oncology S. Luigi- S. Currò, Catania; 8 S. Maria Hospital, Terni; 9 Civic Hospital, Casalpusterlengo; 10 University of Cagliari; 11 University of Florence, Florence; 12 Pierantoni Hospital, Forl
; 13 University and Mauriziano Hospital, Turin
* Correspondence to: Prof. F. Boccardo, National Cancer Research Institute and the University of Genoa, Italy, Largo R. Benzi 10, 16132 Genoa, Italy. Tel: +39-010-5600503; Fax: +39-010-352753; E-mail: f.boccardo{at}unige.it
Background: Tamoxifen, for many years the ‘gold standard’ in the adjuvant setting for the management of endocrine sensitive early breast cancer, is associated with an increased risk of endometrial cancer and other life-threatening events. Moreover, many women relapse during or after tamoxifen therapy due to the development of resistance. This provided the rationale for a switching trial with anastrozole, the updated results of which are reported here.
Patients and methods: This trial investigated the efficacy of switching to anastrozole for women already receiving tamoxifen. After 2–3 years of tamoxifen treatment, postmenopausal, node-positive, ER-positive patients were randomized to receive either anastrozole 1 mg/day or to continue tamoxifen, 20 mg/day, giving a total duration of 5-years treatment. The primary end point was disease-free survival and secondary endpoints were event-free survival, overall survival and safety.
Results: A total of 448 patients were enrolled. At a median follow-up time of 64 months (range 12–93), 63 events had been reported in the tamoxifen group compared with 39 in the anastrozole group [HR 0.57 (95% CI 0.38–0.85) P = 0.005]. Relapse-free and overall survival were also longer in the anastrozole group [HR 0.56 (95% CI 0.35–0.89) P = 0.01 and 0.56 (95% CI 0.28–1.15) P = 0.1]. However, the latter difference was not statistically significant. Overall more patients in the anastrozole group experienced at least one adverse event (209 versus 151: P = 0.000). However, numbers of patients experiencing serious adverse events were comparable (37 versus 40, respectively: P = 0.7).
Conclusions: Switching to anastrozole after the first 2–3 years of treatment was confirmed to improve event-free and relapse-free survival of postmenopausal, node-positive, ER-positive early breast cancer patients already receiving adjuvant tamoxifen.
Key words: anastrozole, switching, adjuvant therapy, breast cancer
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  J. G. H. van Nes, C. Seynaeve, E. Maartense, R. M. H. Roumen, R. S. de Jong, L. V. A. M. Beex, W. M. Meershoek-Klein Kranenbarg, H. Putter, J. W. R. Nortier, C. J. H. van de Velde, et al. Patterns of care in Dutch postmenopausal patients with hormone-sensitive early breast cancer participating in the Tamoxifen Exemestane Adjuvant Multinational (TEAM) trial Ann. Onc., October 29, 2009; (2009) mdp419v1. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. C. Mahoney, T. Bevers, E. Linos, and W. C. Willett Opportunities and Strategies for Breast Cancer Prevention Through Risk Reduction CA Cancer J Clin, November 3, 2008; (2008) CA.2008.0016v1. [Abstract] [Full Text]
|
|
|
|
 |
|
 E. P. Mamounas, J.-H. Jeong, D. L. Wickerham, R. E. Smith, P. A. Ganz, S. R. Land, A. Eisen, L. Fehrenbacher, W. B. Farrar, J. N. Atkins, et al. Benefit From Exemestane As Extended Adjuvant Therapy After 5 Years of Adjuvant Tamoxifen: Intention-to-Treat Analysis of the National Surgical Adjuvant Breast and Bowel Project B-33 Trial J. Clin. Oncol., April 20, 2008; 26(12): 1965 - 1971. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. Ponzone, P. Mininanni, E. Cassina, F. Pastorino, and P. Sismondi Aromatase inhibitors for breast cancer: different structures, same effects? Endocr. Relat. Cancer, March 1, 2008; 15(1): 27 - 36. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. U. Lin and E. P. Winer Advances in Adjuvant Endocrine Therapy for Postmenopausal Women J. Clin. Oncol., February 10, 2008; 26(5): 798 - 805. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Aebi and M. Rabaglio Overview of Current Approaches to Adjuvant Endocrine Therapy ASCO Educational Book, January 1, 2008; 2008(1): 9 - 13. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. Bao and N. E. Davidson How We Maintain Bone Health in Early-Stage Breast Cancer Patients on Aromatase Inhibitors J. Oncol. Pract, November 1, 2007; 3(6): 323 - 325. [Full Text] [PDF]
|
|