Fulvestrant (Faslodex™) versus anastrozole for the second-line treatment of advanced breast cancer in subgroups of postmenopausal women with visceral and non-visceral metastases: combined results from two multicentre trials

Mauriac, L.; Pippen, John; Albano, J.; Gertler, S.; Osborne, C. Kent

doi:10.1016/s0959-8049(03)00199-0

Cited by 68 publications

(41 citation statements)

References 7 publications

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“…All patients taking part in these trials had chemotherapy-resistant EOC and therefore represent a group with a poor prognosis. Similar results were reported in breast cancer patients with visceral metastases who received anastrazole (RR, 7%-14%) or exemestane (RR, 13.5%-25%) [82][83][84][85]. Endocrine treatment in breast cancer is generally more beneficial for patients with soft tissue metastases or low-volume disease.…”

Section: Discussionsupporting

confidence: 72%

Revisiting the Role of Antiandrogen Strategies in Ovarian Cancer

et al. 2011

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After completing this course, the reader will be able to:1. Explain the role of the androgen axis in the development of ovarian cancer.2. Discuss the potential compounds with anti-androgen activity that can be assessed for the treatment of patients with ovarian cancer.This article is available for continuing medical education credit at CME.TheOncologist.com. CME CME ABSTRACTAndrogen receptors are frequently expressed in epithelial ovarian cancer (EOC). Their role in the development of EOC is not fully understood. In the present review we first discuss the epidemiological data linking a hyperandrogen state to a higher risk for ovarian cancer, second describe in vitro studies of the role of androgens in influencing the growth of EOC, and finally review the completed clinical trials with compounds that exploit the androgen axis in patients with ovarian cancer. The therapeutic approaches that inhibit androgen signaling have so far produced only modest response rates. In the light of new data regarding the role of androgen stimulation in the evolution of EOC and the emergence of new compounds used for the treatment of other hormone-driven malignancies, such as prostate and breast cancer, we provide suggestions for new studies of antiandrogen therapeutics in the treatment of EOC. A specific example is the new agent abiraterone. In addition, we propose a panel of molecules that could be assessed as potential biomarkers that may aid patient selection for this approach in the future. The Oncologist

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Section: Discussionsupporting

confidence: 72%

Revisiting the Role of Antiandrogen Strategies in Ovarian Cancer

et al. 2011

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“…Previous trials have shown that fulvestrant is active in patients with visceral metastases [23][24][25][26]. However, direct indicators and surrogates for disease aggressiveness would still be expected to exert some negative influence on response and survival.…”

Section: Discussionmentioning

confidence: 99%

Benefits of early and prolonged fulvestrant treatment in 848 postmenopausal advanced breast cancer patients

Warm

Kates

Overkamp³

et al. 2010

Breast Cancer Res Treat

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Purpose: Response to fulvestrant and survival in postmenopausal hormone-sensitive advanced breast cancer was investigated within a non-randomized, In-Practice Evaluation Program, with the aim of optimizing treatment decisions.Methods: 848 patients (median age 64 years; 52% co-morbidity; 78% prior palliative therapy; median 4 prior regimens) received monthly fulvestrant injections (250 mg/month) and were followed-up threemonthly for 9 months.

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“…Combined data from two Phase III trials comparing fulvestrant and anastrozole following anti-oestrogen failure found that both drugs were active in patients with VM [6]. In line with the present analyses, some endpoints favoured fulvestrant, with objective response rates of 15.7% and 13.2% and median durations of response of 17.5 months and 11.7 months for fulvestrant and anastrozole, respectively [6]. Furthermore, pooled data from a compassionate-use programme of 123 fulvestrant have reported CB in 32.4% of patients with VM [14].…”

Section: Discussionmentioning

confidence: 99%

“…In a subgroup analysis of combined data from these trials, both agents demonstrated similar activity in patients with VM, with objective response and clinical benefit (CB) endpoints favouring fulvestrant, although the differences between treatments were not statistically significant [6]. In another double-blind, randomised Phase III trial comparing exemestane versus megestrol acetate (Megace TM ) after tamoxifen failure, exemestane demonstrated better activity than megestrol acetate in patients with VM [4].…”

Section: Introductionmentioning

confidence: 98%

“…Phase III clinical trials of endocrine treatments for patients with VM have been mainly limited to patients with visceral disease that is not rapidly progressing or symptomatic [4][5][6]. Analyses of treatment benefit in this subgroup of patients are important, as they provide insights into the usefulness of endocrine therapy as an alternative to chemotherapy in this clinical setting.…”

Section: Introductionmentioning

confidence: 99%

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Activity of fulvestrant versus exemestane in advanced breast cancer patients with or without visceral metastases: data from the EFECT trial

Mauriac

Romieu²,

Bines

2008

Breast Cancer Res Treat

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Purpose Patients with visceral metastases (VM: lung and/or liver metastases) are generally regarded as being less responsive to hormonal therapy, and chemotherapy often becomes the default treatment. This paper reports a subgroup analysis from EFECT (The Evaluation of Faslodex versus Exemestane Clinical Trial) examining the efficacy of fulvestrant and exemestane in patients with or without VM. Methods EFECT is a randomised, doubleblind, multicentre, Phase III trial in postmenopausal women with advanced breast cancer progressing or recurring after prior non-steroidal aromatase inhibitor therapy. Results Overall, approximately 57% of patients in EFECT had visceral involvement. Fulvestrant and exemestane demonstrated clinical benefit in 29.1% and 27.2% of patients with VM, respectively. Median duration of response was 13.5 vs 10.8 months and median duration of clinical benefit was 9.9 vs 8.1 months, respectively. Conclusions These results encourage the use of endocrine agents such as fulvestrant in treating patients with advanced breast cancer and VM.

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Fulvestrant (Faslodex™) versus anastrozole for the second-line treatment of advanced breast cancer in subgroups of postmenopausal women with visceral and non-visceral metastases: combined results from two multicentre trials

Cited by 68 publications

References 7 publications

Revisiting the Role of Antiandrogen Strategies in Ovarian Cancer

Revisiting the Role of Antiandrogen Strategies in Ovarian Cancer

Benefits of early and prolonged fulvestrant treatment in 848 postmenopausal advanced breast cancer patients

Activity of fulvestrant versus exemestane in advanced breast cancer patients with or without visceral metastases: data from the EFECT trial

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