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Home: Oncology Leader Commentary: Andrew D. Seidman, MD

Click on the topic below for comments by Dr Andrew D. Seidman to comment on. You will also find links to related articles and clinical trials.

HER-2 and selection of adjuvant therapy
Adjuvant chemotherapy for node-positive patients
Adjuvant chemotherapy plus tamoxifen in ER+ patients
Aromatase inhibitors in women with increased risk of thromboembolic complications
Tamoxifen rechallenge in the metastatic setting
Trials of adjuvant Arimidex
Aromatase inhibitors in women who cannot receive adjuvant tamoxifen
Choice of aromatase inhibitors
Chemotherapy followed by endocrine therapy for metastatic disease
Herceptin for metastatic disease
Herceptin as a single agent for metastatic disease
HER-2 assays
Trials correlating activity of Herceptin with HER 2 assay
Effect of Herceptin in "HER2-negative" patients

Aromatase inhibitors in women with increased risk of thromboembolic complications

Interview with Neil Love, MD from Breast Cancer Update for Medical Oncologists, Program 3 2000

Play Audio Below:

There are some patients who both significantly will benefit from antiestrogen treatment and also, who are such high risk for thromboembolic phenomenon. Based on what I’ve seen with aromatase inhibitors in the setting of metastatic disease, I think its highly likely that they will be as active if not perhaps more active than selective estrogen receptor modulators in the adjuvant setting. So I did have a patient who developed a deep vein thrombosis during CMF, and when it came time to give her tamoxifen, we both opted to use the Arimidex. Again, recognizing we’re treading into unknown territory but still desiring to do something other than observation.

Relevant Articles:

Anastrozole versus tamoxifen as first-line therapy for advanced breast cancer in 668 postmenopausal women: Results of the tamoxifen or arimidex randomized group efficacy and tolerability study. Bonneterre, J.; Thurlimann, B.; Robertson, J. F. R.; Krzakowski, M.; Mauriac, L.; Koralewski, P.; Vergote, I.; Webster, A.; Steinberg, M., and von Euler, M. Journal of Clinical Oncology. 18(22):3748-3757, 2000 Nov 15.

Anastrozole is superior to tamoxifen as first-line therapy for advanced breast cancer in postmenopausal women: Results of a North American multicenter randomized trial.
Nabholtz, J. M.; Buzdar, A.; Pollak, M.; Harwin, W.; Burton, G.; Mangalik, A.; Steinberg, M.; Webster, A., and von Euler, M. Journal of Clinical Oncology. 18(22):3758-3767, 2000 Nov 15.

Relevant Clinical Trials:

Phase III Randomized Study of Letrozole Versus Placebo in Women with Resected Breast Cancer After Completion of Treatment with Adjuvant Tamoxifen

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