Optimal adjuvant hormonal therapy in postmenopausal women with hormone-receptor-positive early breast cancer: have we answered the question?

2010 ◽  
Vol 12 (9) ◽  
pp. 614-620 ◽  
Author(s):  
Alfonso Sánchez-Muñz ◽  
Nuria Ribelles ◽  
Emilio Alba
Keyword(s):  
Breast Cancer ◽  
Postmenopausal Women ◽  
Early Breast Cancer ◽  
Hormonal Therapy ◽  
Hormone Receptor ◽  
Adjuvant Hormonal Therapy ◽  
Hormone Receptor Positive

scholarly journals 0244 A quality initiative: Guideline compliance in postmenopausal women with stage IB-IIIC early breast cancer receiving adjuvant hormonal therapy

The Breast ◽  
2009 ◽  
Vol 18 ◽  
pp. S79
Author(s):  
L. Bosserman ◽  
T. Vanderpool ◽  
N. Bassi ◽  
B. Emilio ◽  
A. Borham ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Postmenopausal Women ◽  
Early Breast Cancer ◽  
Hormonal Therapy ◽  
Adjuvant Hormonal Therapy ◽  
Guideline Compliance ◽  
Stage Ib

The Aromatase Inhibitors as Adjuvant Therapy for Hormone Receptor-Positive Breast Cancer

2003 ◽  
Vol 1 (2) ◽  
pp. 215-221
Author(s):  
Jennifer A. Ligibel ◽  
Eric P. Winer
Keyword(s):  
Breast Cancer ◽  
Aromatase Inhibitors ◽  
Hormonal Therapy ◽  
Hormone Receptor ◽  
Uterine Cancer ◽  
Adjuvant Hormonal Therapy ◽  
Adjuvant Setting ◽  
Modest Improvement ◽  
Hormone Receptor Positive ◽  
Positive Breast Cancer

Adjuvant hormonal therapy has been shown to decrease the risk of breast cancer recurrence and overall mortality in patients with hormone receptor-positive breast cancer. Tamoxifen has been used in this setting for many years, both in premenopausal and postmenopausal patients. Tamoxifen is not devoid of toxicity, and attempts have been made to develop newer hormonal agents with better efficacy and less toxicity. The aromatase inhibitors have shown equivalent or superior efficacy to tamoxifen in the treatment of metastatic breast cancer, and efforts are underway to determine the role of these agents in early breast cancer. The ATAC trial recently showed that use of the third-generation aromatase inhibitor anastrozole in the adjuvant setting led to a modest improvement in relapse-free survival as compared with tamoxifen. Patients treated with anastrozole were also less likely to develop uterine cancer or experience a thromboembolic event. However, patients treated with anastrozole were more likely than those treated with tamoxifen to suffer a fracture or other musculosketal problem. An ASCO technology assessment panel reviewed the relevant data and issued a consensus statement regarding the use of aromatase inhibitors in the adjuvant setting. In general, the panel favored the continued use of tamoxifen as adjuvant hormonal therapy for most postmenopausal women. Within the next few years, further data from the ATAC trial and from other trials of aromatase inhibitors in the adjuvant setting should be available to guide treatment recommendations for this patient population.

scholarly journals Practical consensus recommendations on duration of adjuvant hormonal therapy in breast cancer

2018 ◽  
Vol 07 (02) ◽  
pp. 142-145 ◽  
Author(s):  
S. Gupta ◽  
M. Singh ◽  
Amish Vora ◽  
G. Babu ◽  
M. Walia ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Hormonal Therapy ◽  
Hormone Receptor ◽  
Early Stage ◽  
Adjuvant Hormonal Therapy ◽  
Breast Cancer Patients ◽  
Term Survival ◽  
Consensus Recommendations ◽  
Hormone Receptor Positive

AbstractOptimization of adjuvant systemic therapy in women with early-stage hormone receptor-positive breast cancer includes the consideration of chemotherapy and duration of hormone therapy. Adjuvant hormonal therapy significantly improves long-term survival of breast cancer patients with hormone receptor-positive disease. Despite the proven clinical efficacy of tamoxifen and aromatase inhibitors, many breast cancer survivors either fail to take the correct dosage at the prescribed frequency (adherence) or discontinue therapy (persistence). Expert oncologist discussed on the duration of adjuvant hormonal therapy for improvement of OS and quality of life of breast cancer patients by providing reduction in recurrence and mortality. This expert group used data from published literature, practical experience and opinion of a large group of academic oncologists to arrive at this practical consensus recommendations for the benefit of community oncologists.

Cost-effectiveness of letrozole and anastrozole as adjuvant therapy for hormone receptor positive early breast cancer in postmenopausal women

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 10577-10577
Author(s):  
T. E. Delea ◽  
J. Karnon ◽  
V. Barghout ◽  
S. K. Thomas ◽  
N. L. Papo
Keyword(s):  
Breast Cancer ◽  
Cost Effectiveness ◽  
Adjuvant Therapy ◽  
Postmenopausal Women ◽  
Early Breast Cancer ◽  
Hormone Receptor ◽  
System Perspective ◽  
Healthcare System Perspective ◽  
Hormone Receptor Positive ◽  
The Cost

10577 Background: The BIG 1–98 and ATAC studies demonstrated that, in postmenopausal women with hormone receptor positive (HR+) early breast cancer, 5 years of initial adjuvant therapy with the aromatase inhibitors (AIs) letrozole (LET) or anastrozole (ANA) is superior to tamoxifen (TAM). The cost-effectiveness TAM, LET, and ANA have not been previously evaluated using a consistent methodology. Methods: A Markov model was used to estimate the incremental cost per quality-adjusted life year (QALY) gained with initial adjuvant therapy with LET vs TAM, ANA vs TAM, and LET vs ANA in postmenopausal women with HR+ early stage breast cancer from the US healthcare system perspective. Probabilities of recurrence (including contralateral tumor) and adverse events (endometrial cancer, thromboembolism, fractures, hypercholesterolemia, MI, and stroke) for TAM were based primarily on published US population-based studies and trials of prophylactic TAM vs placebo. Corresponding probabilities for LET and ANA were calculated by multiplying probabilities for TAM by estimated relative risks of LET vs TAM and ANA vs TAM from the BIG 1–98 and ATAC trials respectively. Other probabilities, costs, and health-state utilities were obtained from published studies. Expected lifetime costs and QALYs were estimated for a cohort of HR+ postmenopausal women with early breast cancer, aged 61 years at therapy initiation and discounted at 3% annually. Probabilistic sensitivity analyses were conducted to assess precision of results. Results: Incremental cost per QALY gained for LET vs TAM is $33,536 (95% CI $20,409 to $70,566) and for ANA vs TAM is $38,967 (95% CI $23,826 to $81,904). Compared with ANA, LET is less costly ($9,647 vs $10,190) and gains more QALYs (0.29 vs 0.26), although differences in costs (95% CI -$1,669 to $671) and QALYs (95% CI -0.16 to 0.22) are not statistically significant. Conclusions: In postmenopausal women with HR+ early breast cancer, adjuvant therapy with either LET or ANA is cost-effective from a US healthcare system perspective. Although LET dominates ANA in our base-case analysis, definitive conclusions regarding the cost-effectiveness of LET vs ANA must await results of comparative clinical studies. [Table: see text]

Abstract A52: Receipt of adjuvant hormonal therapy among Medicaid enrollees diagnosed with hormone-receptor positive breast cancer, 2004-2007.

2012 ◽  
Author(s):  
Tisha M. Felder ◽  
Lincy S. Lal ◽  
Dana Stafkey-Mailey ◽  
Phoenix Do ◽  
Kevin Lu ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Hormonal Therapy ◽  
Hormone Receptor ◽  
Adjuvant Hormonal Therapy ◽  
Hormone Receptor Positive ◽  
Positive Breast Cancer
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