Current best practices and rationalistic perspectives in causation-based prevention, early detection and multidisciplinary treatment of breast and gastric cancer

Gastric & Breast Cancer e-journal
DOI: 10.2122/gbc.2012.0247


Adding Fulvestrant to Anastrozole prolongs survival in Breast Cancer.

Eleftheria Ignatiadou, MD.

Affiliation: Dr. Eleftheria Ignatiadou, Department of Surgery, University Hospital of Ioannina, Ioannina, TK 45110, Greece.


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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last update: 30 October 2012