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Titolo:
Management of advanced breast cancer - Defining the role of Anastrozole
Autore:
Keating, GM; Goa, KL;
Indirizzi:
Adis Int Ltd, Auckland 10, New Zealand Adis Int Ltd Auckland New Zealand10 s Int Ltd, Auckland 10, New Zealand
Titolo Testata:
DISEASE MANAGEMENT & HEALTH OUTCOMES
fascicolo: 7, volume: 9, anno: 2001,
pagine: 385 - 402
SICI:
1173-8790(2001)9:7<385:MOABC->2.0.ZU;2-M
Fonte:
ISI
Lingua:
ENG
Soggetto:
2ND-LINE HORMONAL TREATMENT; FIRST-LINE THERAPY; POSTMENOPAUSAL WOMEN; AROMATASE INHIBITORS; MEGESTROL-ACETATE; RANDOMIZED TRIAL; COST-UTILITY; TAMOXIFEN; RISK; TOLERABILITY;
Keywords:
Anastrozole; breast cancer; aromatase inhibitors; disease management; review on treatment;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
72
Recensione:
Indirizzi per estratti:
Indirizzo: Keating, GM Adis Int Ltd, 41 Centorian Dr,Private Bag 65901,Mairangi Bay, Auckland 10,New Zealand Adis Int Ltd 41 Centorian Dr,Private Bag 65901,Mairangi Bay Auckland New Zealand 10
Citazione:
G.M. Keating e K.L. Goa, "Management of advanced breast cancer - Defining the role of Anastrozole", DIS MANAG H, 9(7), 2001, pp. 385-402

Abstract

Breast cancer is the most common malignancy affecting women and imposes a substantial economic burden on society, Estrogen is thought to play a majorrole in both the initiation and promotion of hormone dependent breast cancer, and a number of well recognized risk factors for breast cancel I effectincreased cumulative estrogen exposure (e.g. early menarche, late menopause),Metastatic breast cancer is an incurable condition and the goals of treatment are to relieve symptoms, improve health-related quality of life and prolong life, Women with hormone receptor-positive disease are candidates for hormonal treatment, In contrast, chemotherapy is traditionally the treatment of choice in those with hormone receptor-negative disease or symptomatic visceral disease. Anastrozole is a highly selective nonsteroidal type II aromatase inhibitorthat suppresses plasma and intratumoral estrogen levels. The results of 2 multicenter, randomized, double-blind trials have shown anastrozole to be at least as effective as tamoxifen in the first-line treatment of postmenopausal women with advanced breast cancer, although survival data an lacking, In the smaller of these trials, the median time to disease progression was significantly prolonged (p = 0.005) in anastrozole, compared with tamoxifen, recipients (11.1 vs 5.6 months), although combined analysis of the 2 trials revealed no significant difference between anastrozole and tamoxifen in terms of this end-point,Similarly, anastrozole has been shown to be at least as effective as megestrol in the second-line treatment of postmenopausal women with advanced breast cancer in 2 multicenter randomized studies, Combined analysis of the studies revealed a significant survival advantage (p < 0.035) for anastrozole1 mg/day, compared with megestrol 30mg 1 times daily, recipients (estimated hazard ratio 0.78; 97.5% confidence interval 0.6 to <1). Tolerability is an important consideration in women with advanced breast cancer. The most common adverse events associated with anastrozole therapy were gastrointestinal disturbance, hot flushes, asthenia and pain. Anastrozole is associated with less vaginal bleeding and thromboembolic disease thantamoxifen and less bodyweight gain than megestrol. Anastrozole also appears to be a cost-effective option in the first- and second-line treatment of advanced breast cancer, although data are limited. Conclusion: Current treatment guidelines support the use of anastrozole inthe second-line treatment of postmenopausal women with advanced breast cancer. Although current treatment guidelines do not yet reflect this, data from recent, well designed studies demonstrate that anastrozole is likely to be a viable alternative to tamoxifen in the first-line treatment of postmenopausal women with advanced breast cancer.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 05/07/20 alle ore 12:55:22