Clinical therapeutics
-
Clinical therapeutics · Nov 2005
ReviewAre all aromatase inhibitors the same? A review of controlled clinical trials in breast cancer.
Five years of tamoxifen therapy has been the standard of care for the adjuvant treatment of estrogen receptor-positive early-stage breast cancer for many years and was the first hormonal treatment for postmenopausal women with advanced or metastatic disease. The third-generation aromatase inhibitors (AIs) anastrozole, exemestane, and letrozole offer new treatment options, although their efficacy has not been compared directly in randomized, double-blind, controlled trials in any breast cancer treatment setting. ⋯ Currently, anastrozole and letrozole are associated with the most complete data over the breast cancer care continuum, with efficacy in early-stage, locally advanced, and metastatic disease. In-direct comparisons suggest stronger evidence for the use of letrozole compared with other AIs for breast cancer in postmenopausal women who require estrogen-deprivation therapy. Data from randomized, double-blind comparative studies will help clarify the differences between AIs.