Abstract
Endocrine therapy with an aromatase inhibitor (AI) has been the standard of care for postmenopausal women with hormone-receptor (HR)–positive metastatic breast cancer. In a phase 3, randomized trial of Standard Adjuvant Endocrine Therapy +/- Chemotherapy in Patients With 1-3 Positive Nodes, Hormone Receptor-Positive and Her2-Negative Breast Cancer With Recurrence Score (RS) of 25 or Less (SWOG) the combination of anastrozole and fulvestrant was more effective in improving both progression-free survival and overall survival as compared to anastrozole alone. This drugs' combination provides a new therapeutic option in the first-line treatment of HR-positive postmenopausal women with metastatic breast cancer and opens the door for exploring this combined treatment also in the adjuvant setting for early-stage disease. However, the three deaths occurred in the combined treatment group, the absolute survival benefit of only 1,5 month in progression-free survival and the lack of survival benefit in another similar phase 3 trial of f ulvestrant and anastrozole in combination compared with anastrozole alone as first-line therapy for patients with receptor-positive postmenopausal breast cancer (FACT) require further investigation and careful consideration of all parameters in clinical decision making for choosing first-line treatment in HR-positive metastatic disease.

(Citation: Gastric & Breast Cancer 2012; 11(4): 211-215).

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