Choice
of first-line endocrine therapy for postmenopausal patients
Interview
with Neil Love, MD from Breast Cancer Update for Medical Oncologists,
Program 1 2000
Play
Audio Below:
Dr.
Buzdar: I think it will definitely change our thinking, because
it should be now with the two prospective blind studies. I think
the patients who never had tamoxifen for metastatic disease, did
not receive as an adjuvant therapy. I have no question that it will
replace it, and it is a better choice, because from patient point
of view it has longer control of disease with fewer side effects.
So it has two major advantages which we look for any time we are
looking for a new treatment.
Dr.
Love: So, right now in terms of your therapeutic cascade, if you
see a woman with metastatic breast cancer, ER-positive, you want
to use endocrine manipulation.
Dr.
Buzdar: I would have no question that I would discuss with the woman,
and I would be more inclined to suggest to the woman and offer anastrozole
compared to tamoxifen.
Dr.
Love: I’m kind of curious, if they are having equal efficacy,
would you still be using Arimidex as first-line based on the toxicity?
Dr.
Buzdar: Yes, because if you look at the pooled data, one thing which
we would know for sure, the objective of these trials were not to
think of the superiority. The studies were designed to see if these
treatments are equal. And if that is proven beyond a shadow of a
doubt that these treatments are similar or have the same anti-tumor
activity, if you pool the data and don’t look at these subgroup
analysis or look at the individual trials alone.
Dr.
Love: So, its power to demonstrate equivalence, and it has done
at least that.
Dr.
Buzdar: It has done unequivocally that.
Dr.
Love: And in your opinion, in ER-positive patients, it’s demonstrated
superiority in efficacy?
Dr.
Buzdar: I think that is real, even though some people had reservations
about it. I feel that endocrine therapy – it is that you have
to identify the patient population who it is going to work.
Critique
of survival update analysis from two phase III anastrozole clinical
trials. Buzdar, A. U.; Wood; Wolter; Vogel; Bland, and Ravdin.
Annals of Surgical Oncology. 6(8 Suppl S):8S-11S, 1999 Dec.No
abstract
