New Breast Cancer Drugs Top Tamoxifen
Patients on Aromatase Inhibitors Live Longer, Study Shows
Tamoxifen Still Needed
Daniel Hayes, MD, who directs the breast cancer program at the University of Michigan Comprehensive Cancer Center, says the evidence has long pointed to a modest survival benefit for advanced breast cancer patients taking aromatase inhibitors.
He adds that there is increasingly strong evidence the newer drugs are also more effective than tamoxifen in patients with less advanced disease.
But that doesn't mean tamoxifen no longer has a place in breast cancer treatment, he tells WebMD.
Individual patients may still respond better to tamoxifen or they may experience fewer side effects on the older hormone therapies, he says. And it may be that patients whose cancers progress while they are taking aromatase inhibitors can benefit from switching to tamoxifen.
"These are all unanswered questions at this point," Hayes says. "We may be able to individualize treatment with these two drugs in the future."
Eric Winer, MD, who directs the Breast Oncology Center at Boston's Dana-Farber Cancer Institute, agrees.
"Ultimately, the hope is that we will be able to identify tumor or patient characteristics that can guide us in the choice of treatment," he tells WebMD. "It may be that some patients will benefit most from treatment with an aromatase inhibitor immediately, while another will do better with a few years of tamoxifen, followed by an aromatase inhibitor."
The American Society of Clinical Oncology now recommends the use of aromatase inhibitors for the treatment of hormone-receptor-positive tumors in postmenopausal women, either as first-line or second-line treatment. Winer chaired the ASCO panel which made the recommendation.
"These drugs are clearly beneficial, but the jury is still very much out on whether patients should start with these drugs and take them for five years, or whether taking tamoxifen for a few years followed by an aromatase inhibitor may be beneficial."