Single Chemotherapy Effective for Breast Cancer

08/28/2009 - News

Single Chemotherapy Effective for Breast Cancer

By: June Chen, MD

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Early breast cancer is typically treated with surgery to remove the tumor, followed by chemotherapy. One approach to breast cancer chemotherapy is sequential treatment with an aromatase inhibitor and tamoxifen.

Another approach is to use monotherapy with an aromatase inhibitor. In the August 20, 2009 issue of New England Journal of Medicine, researchers report that sequential treatment is no better than monotherapy in improving disease-free survival for postmenopausal women with hormone-responsive breast cancer.

The Breast International Group (BIG) I-98 trial involved over 10,000 postmenopausal women with hormone-receptor-positive breast cancer who were randomly assigned to receive 5 years of tamoxifen monotherapy, 5 years of letrozole (an aromatase-inhibitor) monotherapy, or 2 years of treatment with one agents followed by 3 years of treatment with the other. BIG I-98 researchers found that, at 71 months after randomization, disease-free survival was similar among breast cancer patients treated with letrozole alone and breast cancer patients treated with sequential therapy. There was also no statistically significant difference in overall survival between the two monotherapies.
 
The study authors suggest that their findings indicate that letrozole should be the first breast cancer therapy used after surgery, especially in women who are at risk for early recurrence. However, economic considerations may affect the approach to breast cancer therapy because letrozole is much more expensive than tamoxifen. Additional research is still needed to determine the optimal length of treatment with letrozole in postmenopausal women with hormone-responsive breast cancer.
 

Source:

NEJM. 2009;361:766-776.

Created on: 08/28/2009
Reviewed on: 08/28/2009

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