Outcome of Fulvestrant in Pretreated Metastatic Breast Cancer Patients in a Medical Center in Taiwan

Abstract

Background: Fulvestrant is a selective estrogen receptor antagonist, indicated for treating hormone receptor-positive metastatic breast cancer in postmenopausal women with disease progression following antiestrogen therapy. This is the first observational study in Taiwan to assess the efficacy and tolerability of fulvestrant in Taiwanese women.Methods: A total of 15 postmenopausal women with metastatic breast cancer, who were treated with endocrine and cytotoxic agents and still had progression of disease, were begun on fulvestrant (250 mg intramuscular injection monthly) from 2005 to 2009 in a medical center in Taiwan. We present the observations while treating these patients.Results: All patients had been previously treated with aromatase inhibitors (AI), while 12 of them also received chemotherapy before fulvestrant. Nine patients (60%) achieved stable disease after an average of 25.4 doses of fulvestrant, and the stable disease lasted for an average of 2.7 years (range, 2 to 5 years). Six patients (40%) experienced progression of disease after an average of 10.8 doses of fulvestrant, and 5 of them (33.3%) died. No patient discontinued fulvestrant treatment due to adverse events, and only minor reactions were reported.Conclusions: Fulvestrant was effective and well-tolerated in treating patients with metastatic breast cancer who had progression on endocrine therapy and/or chemotherapy. It offers another treatment option for patients with terminal disease, and may help them maintain a better quality of life.