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Standardized Cup Sizes
Breast Size 32aa
Celebrity example Mena Suvari
Breast Size 34A
Celebrity example Audrey Hepburn
Breast Size 36B
Celebrity example Claudia Schiffer
Breast Size 34C
Celebrity example Angelina Jolie
Breast Size 40D
Celebrity example Catherine Bell
Breast Size 40F
Celebrity Example Anna Nicole
Smith Breast Size EE
Celebrity Example Dolly Parton |
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Letrozole following tamoxifen may benefit women with breast cancer
Letrozole following tamoxifen may benefit women with breast
cancer
September 07, 2005
Switching to the drug letrozole following 5 years of treatment
with tamoxifen reduces the risk of hormone-dependent breast cancer
recurrence, but not overall survival, among postmenopausal women,
according to a new study in the September 7 issue of the Journal of
the National Cancer Institute.
The standard treatment for women with estrogen receptor-positive
breast cancer is 5 years of tamoxifen. Extending the treatment past
5 years has not been associated with any additional improvement in
survival, and many women experience new primary tumors and relapses
after they go off the drug.
Tamoxifen works by inhibiting the effects of estrogen. However,
after 5 years of exposure to the drug, cancer cells may become
resistant to or even dependent on it.
Newer drugs, called aromatase
inhibitors, can selectively inhibit the enzyme aromatase, thus
lowering the levels of estrogen. Previous reports have suggested
that the tumor cells involved with cancer recurrence may be
vulnerable to these drugs after building up a resistance to
tamoxifen.
To test whether an aromatase inhibitor called letrozole (Femara)
could extend the protective effect of tamoxifen beyond 5 years, the
National Cancer Institute of Canada's Clinical Trials Group in
collaboration with the North American Breast Intergroup launched a
clinical trial called the MA.17 trial.
They randomly assigned 5,187
postmenopausal women who had already received 5 years of tamoxifen
for breast cancer to take either a placebo or letrozole for an
additional 5 years.
After median follow-up of 30 months, in the current study Paul
E. Goss, M.D.
, Ph.D., of the Massachusetts General Hospital in
Boston, and colleagues reported that the women taking letrozole had
a significantly better overall disease-free survival rate and
distant disease-free survival rate (survival without metastasis)
than women in the placebo group. They found that 92 (3.
6%) of the
2,583 in the letrozole group experienced a recurrence or
contralateral breast cancer (cancer in the opposite breast),
compared with 155 (6%) of the 2,587 taking the placebo.
Although the authors originally planned for a 5-year study, the
trial was halted after 4 years, and the placebo patients were given
the option of switching to the letrozole treatment. Some of the
interim results were previously published in 2003, however this new
study includes a full analysis of the results, including
information on patient subsets. For example, although the authors
found similar overall survival rates throughout the whole study
population, they also found that the subset of patients with lymph
node-positive cancer had better overall survival on letrozole then
on the placebo.
The women taking letrozole experienced more side effects from
their treatment then the women taking placebo. For example, 8.1% of
women taking letrozole were diagnosed with osteoporosis, compared
with 6.0% in the placebo group; 58% of the letrozole group reported
having hot flashes, compared with 54% of those on placebo.
The
authors attribute many of these events to the estrogen depletion
caused by the drug.
The authors note that their study is based on a relatively short
median follow-up. However, they remain encouraged that the data
confirms a "substantial reduction in risk of recurrence and
excellent tolerability with extended adjuvant letrozole." They
conclude, "Adjuvant letrozole should be discussed with all
postmenopausal women completing standard adjuvant tamoxifen
therapy.
"
Journal of the National Cancer Institute
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