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Increased survival rates for breast cancer patients who switch to Aromasin

An article published in Lancet Oncology has revealed that women with breast cancer who switch from tamoxifen to Pfizer's aromatase inhibitor, Aromasin (exemestane), increase their rates of survival

An article published in Lancet Oncology has revealed that women with breast cancer who switch from tamoxifen to Pfizer's aromatase inhibitor, Aromasin (exemestane), increase their rates of survival, although an increased risk of bone fractures was noted.

The majority of breast cancers are hormone-positive, the growth of which is stimulated by the hormones estrogen and/ or progesterone. Women with hormone-positive breast cancer are generally treated with hormone therapy, an approach in which estrogen and progesterone are either suppressed or blocked from entering cancer cells.

Tamoxifen is currently the hormone therapy treatment of choice for breast cancer patients. Aromatase inhibitors, however, have recently demonstrated improved outcomes compared with tamoxifen. Researchers are assessing the side effects associated with aromatase inhibitors in order to reduce or prevent these complications altogether.

Researchers affiliated with the Intergroup Exemestane Study (IES) conducted a subgroup analysis on the effects of exemestane on bone health of women with breast cancer. The IES trial included postmenopausal women with early, hormone-positive breast cancer who were initially treated with tamoxifen. One group of patients in the trial continued therapy with tamoxifen, while the other switched to exemestane. The results showed that women who switched to exemestane had improved survival compared with women who remained on tamoxifen.

The subgroup analysis from the IES trial regarding bone health revealed the following outcomes:

1) Bone mineral density was lowered by 2.7 per cent in the lumbar spine and 1.4 per cent in the hip among patients who switched to exemestane

2) At 58 months follow-up, 7 per cent of patients who switched to exemestane had developed bone fractures, compared with 5 per cent who continued to stay on tamoxifen

3) No patients with normal bone mineral density at the initiation of the trial developed osteoporosis

The researchers concluded that postmenopausal women with hormone-positive breast cancer who switch from tamoxifen to exemestane have reduced bone mineral density and increased bone fractures compared with women who continue treatment with tamoxifen. However, previous findings from this trial have demonstrated that overall survival is improved among patients who switch to exemestane.

Dr Emma Pennery, Nurse Consultant at Breast Cancer Care said of the findings: "These updated results confirm that the benefits of using Aromatase Inhibitor drugs, like Aromasin, are sustained over time. The results could help to inform when and how to use this type of drug in the most effective way."

"Aromasin is already licensed and has been approved for use by NICE so people should already have access to it throughout the UK. We know, from talking to people with breast cancer every day, that they value research which reinforces knowledge of the most effective ways to treat the disease," added Pennery.

Pfizer's Q4 FY06 sales of Aromasin were USD 91 million, up 29 per cent on USD 71 million in Q4 FY05. FY06 global sales were USD 320 million, up 30 per cent on USD 247 million in FY05.

14th February 2007

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