Meta-analysis of trials comparing anastrozole and tamoxifen for adjuvant treatment of postmenopausal women with early breast cancer

It was aimed to review the literature and make a meta-analysis of the trials on both upfront, switching, and sequencing anastrozole in the adjuvant treatment of early breast cancer. The PubMed, ClinicalTrials.gov and Cochrane databases were systematically reviewed for randomized-controlled trials co...

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Bibliographic Details
Published inCurrent controlled trials in cardiovascular medicine Vol. 9; no. 1; p. 47
Main Authors Aydiner, Adnan, Tas, Faruk
Format Journal Article
LanguageEnglish
Published England BioMed Central Ltd 29.07.2008
BioMed Central
BMC
Subjects
Breast cancer
Cancer therapies
Chemotherapy
Clinical trials
Diagnosis
Dosage and administration
Drug therapy
Estrogens
Meta-analysis
Patient outcomes
Patients
Tamoxifen
Womens health
Turkey
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Summary:It was aimed to review the literature and make a meta-analysis of the trials on both upfront, switching, and sequencing anastrozole in the adjuvant treatment of early breast cancer. The PubMed, ClinicalTrials.gov and Cochrane databases were systematically reviewed for randomized-controlled trials comparing anastrozole with tamoxifen in the adjuvant treatment of early breast cancer. The combined hazard rate of 4 trials for event-free survival (EFS) was 0.77 (95%CI: 0.70-0.85) (P < 0.0001) for patients treated with anastrozole compared with tamoxifen. In the second analysis in which only ITA, ABCSG 8, and ARNO 95 trials were included and ATAC (upfront trial) was excluded, combined hazard rate for EFS was 0.64 (95%CI: 0.52-0.79) (P < 0.0001). In the third analysis including hazard rate for recurrence-free survival (excluding non-disease related deaths) of estrogen receptor-positive patients for ATAC trial and hazard rate for EFS of all patients for the rest of the trials, combined hazard rate was 0.73 (95%CI: 0.65-0.81) (P < 0.0001). Anastrozole appears to have superior efficacy than tamoxifen in the adjuvant hormonal treatment of early breast cancer. Until further clinical evidence comes up, aromatase inhibitors should be the initial hormonal therapy in postmenopausal early breast cancer patients and switching should only be considered for patients who are currently receiving tamoxifen.
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ISSN:1745-6215
1745-6215
DOI:10.1186/1745-6215-9-47