Toxicity of Aromatase Inhibitors May Explain Lack of Overall Survival Improvement

Extract

The toxicities associated with aromatase inhibitors (AIs) may explain the lack of overall survival improvement compared with tamoxifen, according to a study published August 22 in the Journal of The National Cancer Institute.

AIs are a class of drugs used to treat breast cancer in postmenopausal women. The drugs are normally taken as an alternative to tamoxifen or after initial treatment with tamoxifen. In general, they are associated with as reduction in breast cancer recurrence but not in improved survival. Furthermore, the drugs are associated with a number of concerning adverse toxic effects compared with tamoxifen.

To examine whether the relative toxicity of AIs versus tamoxifen may explain the lack of overall survival benefit in postmenopausal breast cancer patients, Eitan Amir, MB ChB, of the Division of Medical Oncology and Hematology at Princess Margaret Hospital in Toronto, Ontario and colleagues conducted a systematic review to identify all randomized trials which compared AIs and tamoxifen in postmenopausal women. They then performed a meta-analysis of the data from the selected randomized trials. Their meta-analysis used data from seven trials enrolling 30,023 patients.