Combining
tamoxifen and an aromatase inhibitor in postmenopausal women
Interview
with Neil Love, MD from Breast Cancer Update for Medical Oncologists,
Program 2 2000
Play
Audio Below:
When
we talk about aromatase inhibitors we’re talking about postmenopausal
women and in a way we’re really saying the same thing. In other
words, we’re saying that removing remaining endocrine function
is a critical factor. Removing estrogens is a critical factor, just
as it is in the younger women, and although I did a trial with aminoglutethimide
tamoxifen very early in my career and didn’t see a real benefit,
it was premenopausal and postmenopausal – it was small. It
wouldn’t surprise me that with some of the new aromatase inhibitors
that we’ll even be able to duplicate in postmenopausal women
some of the things we’ve seen in premenopausal women. There’s
no question – the first rule that is we use the least toxic
is already swung into effect – so that in the randomized trials
of aromatase inhibitors versus a progestin, the aromatase inhibitors
are definitively less toxic. And they have now pretty much supplanted
progestins unless a woman wants to gain weight or has some other
reason to get on progestin. And, of course, there are the data now
that are rather provocative that suggest in first-line trials that
the aromatase inhibitors might even be better than tamoxifen in
first-line.
Relevant
Articles:
Combined
endocrine therapy for breast cancer - New life for an old idea?
Davidson, N. E. (Reprint available from: Davidson NE Johns Hopkins
Oncol Ctr 1650 Orleans St,Rm 409 Baltimore, MD 21231 USA). Journal
of the National Cancer Institute. 92(11):859-860, 2000 Jun 7. No
abstract
