Developments in Breast Cancer 2017–2018: New Drugs, New Drug Classes-and the Prospect of More to ComeDecember 15th 2017
This interview provides perspective on developments in breast cancer treatment in 2017, as well as a preview of what we can expect to change in the treatment of breast cancer in 2018.
Commentary (Kaklamani/Gradishar): Adjuvant Hormonal Therapy in Early Breast CancerOctober 1st 2005
The use of adjuvant endocrinetherapy in early-stage breastcancer is thought to eradicatemicrometastatic disease that may leadto systemic recurrences. Until relativelyrecently, the standard adjuvantendocrine therapy option was tamoxifen.Data from the Early Breast CancerTrialists’ Collaborative Group(EBCTCG) overview analysis reporteda 50% reduction in the risk of relapseand a 28% reduction in the riskof death in estrogen receptor (ER)-positive patients treated with 5 yearsof tamoxifen. This benefit was observedregardless of menopausal orlymph node status and whether or notpatients were receiving chemotherapy.There was no such benefit documentedin ER-negative cancersreceiving tamoxifen. Tamoxifen hasalso been associated with a 47% reductionin the risk of developing contralateralbreast cancer.
Commentary (Kaklamani/O’Regan): Aromatase Inhibitors as Adjuvant Therapy in Breast CancerMarch 1st 2003
The use of aromatase inhibitorshas increased dramatically inthe past few years as a resultof the emergence of new, more specificagents, such as anastrozole(Arimidex), exemestane (Aromasin),and letrozole (Femara). This class ofagents effectively blocks the peripheralformation of estradiol, decreasingits concentration to less than 10%,while maintaining selectivity.Evaluation of these selective aromataseinhibitors as adjuvant therapyfor early-stage breast cancer wasbased on the findings of trials inmetastatic breast cancer, summarizedby Visvanathan and Davidson, thatdemonstrated the equivalence and,in some cases, superiority of thearomatase inhibitors comparedwith megestrol and tamoxifen,including their superior side-effectprofile.[2-4]