Abstract
The third-generation aromatase inhibitors (AIS) are largely replacing tamoxifen in the adjuvant treatment of early-stage breast cancer in postmenopausal women with hormone receptor-positive tumours. To date, multiple trials have been conducted comparing tamoxifen treatment with an AI, and all have demonstrated improved disease-free survival with AI treatment. Trials have included direct 5-year comparisons between tamoxifen and an AI, switching to an AI within 5 years after initial tamoxifen treatment, or extending treatment with an AI after 5 years of completed tamoxifen treatment. Some of these trials have been completed; others are ongoing; and head-to-head trial comparisons of individual AIS are also in progress. The present article summarizes the data obtained from various clinical trials of hormonal therapy for early breast cancer. It also reviews recent data so as to shed light on the current status of these therapies. The focus is on the efficacy of treatment with an AI. Toxicity is discussed in the second article in this supplement.
Highlights
The efficacy of tamoxifen as adjuvant therapy for women with estrogen receptor–positive early breast cancer has been clearly demonstrated
Adjuvant tamoxifen treatment has been associated with a 31% reduction in the annual breast cancer mortality rate among hormone receptor–positive women with early breast cancer 1, initially making it a standard of care for this patient population
Data so far have unequivocally shown that, as compared with tamoxifen, the ais offer superior benefit in dfs, and adjuvant ai treatment is accepted as the standard of care in early breast cancer
Summary
The efficacy of tamoxifen as adjuvant therapy for women with estrogen receptor (er)–positive early breast cancer has been clearly demonstrated. Adjuvant tamoxifen treatment has been associated with a 31% reduction in the annual breast cancer mortality rate among hormone receptor–positive women with early breast cancer 1, initially making it a standard of care for this patient population. Trials of tamoxifen often used os as the primary endpoint, but recent trials comparing the ais with tamoxifen have used other endpoints in addition to os to demonstrate clinical benefit, and so it is important to review the endpoints in the context of current clinical care of postmenopausal women with breast cancer
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