Choosing
first-line endocrine therapy in postmenopausal patients
Interview
with Neil Love, MD from Breast Cancer Update for Medical Oncologists,
Program 1 2000
Play
Audio Below:
Dr.
Locker: When a woman has been on adjuvant tamoxifen for five years,
comes off the drug and, say, relapses late several years later -
the issue has always been, do you put her back on tamoxifen or do
you try something else. The classic teaching has been, since
there is nothing as good as tamoxifen, put her back on the tamoxifen.
At least now, if for whatever reason you don’t want to
do that, you have Arimidex, which is equally good, if not better.
And so I think it helps us in a specific dilemma, not all that uncommon
a dilemma, which is the late relapse after adjuvant hormonal therapy.
It’s a very, very, very exciting study. And, again, I think
it has to be emphasized, at a minimum, the drugs are equivalent
and the Arimidex may even be better. And of course the
side effect profile is better.
Dr.
Love: Well, and side effects in terms of thromboembolic complications?
Dr.
Locker: Thromboembolic complications - absolutely. There were hot
flashes on both arms. You do get hot flashes, but the uterine cancer
risk - although, again, I don’t think we have long enough data
to say that and this isn’t the metastatic setting where uterine
cancer is much less of an issue - but, the uterine cancer risk is
likely to be less, if not at all. The thromboembolic issue is better
and remember in the metastatic setting, that is a high-risk group
priority, so that does make a difference. And then there is the
psychological factor of a drug with a different mechanism of action,
different profile of toxicity.
