HER2 Support Group Forums - View Single Post - for all breast cancer (her2+ patients not specifically)

Lani · 11-17-2006, 11:18 AM

The meta-analysis revealed that patients who switched to anastrozole had fewer disease recurrences (92, vs 159 on tamoxifen) and deaths (66, vs 90 on tamoxifen). This resulted in significant improvements in:
Disease-free survival (hazard ratio [HR], 0.59; P < .0001).
Event-free survival (HR, 0.55; P < .0001).
Distant recurrence-free survival (HR, 0.61; P = .002).
Overall survival (HR 0.71, P = .04).

The researchers note that the patient population of the ITA study (n=448) differed from those in the other 2 studies: the majority were node-positive, and more patients had undergone a mastectomy and received chemotherapy than in the other trials. However, these differences should not affect outcome, as the meta-analysis used individual patient data, they comment. “Indeed, the benefit of anastrozole over tamoxifen was evident irrespective of nodal status [or] tumor size or whether the patient had received chemotherapy.”

“We showed that the benefits of switching to anastrozole in terms of disease- and recurrence-free survival that have been seen in the individual trials translate into a significant benefit in overall survival,” Dr. Jonat commented. The technique of meta-analysis “increases the power and precision of the analysis, helps to avoid bias or random error, and can therefore address questions that cannot be answered from the individual trials.” Despite this powerful technique, however, there are many questions that remain, he added. Future research will need to address the optimum duration of treatment, whether tamoxifen or aromatase inhibitors should be given first, and whether any combinations of other drugs may improve further on these results.

“Clearly, real data from well-designed clinical trials are needed to inform treatment strategies,” the authors note. “However, the survival benefit that emerged from our analysis — and not present in any trial that assessed aromatase inhibitors as initial adjuvant treatment — suggests that a tamoxifen induction period could be beneficial, despite the fact that relapse rates might be highest in the first 2 years.”

Lancet Oncol.

The drug co. sponsored , European studies, mostly didn't test her2 status and many patients with ER+ tumors were treated with hormonal therapy wout chemo (often CMF instead of AC +/-T)

they think there still could be a
beneficial effect of starting with tamoxifen

her2+ patients -? easier time getting AIs despite price diff. (govt decisions)

11-17-2006, 11:18 AM	#2
Lani Senior Member Join Date: Mar 2006 Posts: 4,778	continued...with comment The meta-analysis revealed that patients who switched to anastrozole had fewer disease recurrences (92, vs 159 on tamoxifen) and deaths (66, vs 90 on tamoxifen). This resulted in significant improvements in: Disease-free survival (hazard ratio [HR], 0.59; P < .0001). Event-free survival (HR, 0.55; P < .0001). Distant recurrence-free survival (HR, 0.61; P = .002). Overall survival (HR 0.71, P = .04). The researchers note that the patient population of the ITA study (n=448) differed from those in the other 2 studies: the majority were node-positive, and more patients had undergone a mastectomy and received chemotherapy than in the other trials. However, these differences should not affect outcome, as the meta-analysis used individual patient data, they comment. “Indeed, the benefit of anastrozole over tamoxifen was evident irrespective of nodal status [or] tumor size or whether the patient had received chemotherapy.” “We showed that the benefits of switching to anastrozole in terms of disease- and recurrence-free survival that have been seen in the individual trials translate into a significant benefit in overall survival,” Dr. Jonat commented. The technique of meta-analysis “increases the power and precision of the analysis, helps to avoid bias or random error, and can therefore address questions that cannot be answered from the individual trials.” Despite this powerful technique, however, there are many questions that remain, he added. Future research will need to address the optimum duration of treatment, whether tamoxifen or aromatase inhibitors should be given first, and whether any combinations of other drugs may improve further on these results. “Clearly, real data from well-designed clinical trials are needed to inform treatment strategies,” the authors note. “However, the survival benefit that emerged from our analysis — and not present in any trial that assessed aromatase inhibitors as initial adjuvant treatment — suggests that a tamoxifen induction period could be beneficial, despite the fact that relapse rates might be highest in the first 2 years.” Lancet Oncol. The drug co. sponsored , European studies, mostly didn't test her2 status and many patients with ER+ tumors were treated with hormonal therapy wout chemo (often CMF instead of AC +/-T) they think there still could be a beneficial effect of starting with tamoxifen her2+ patients -? easier time getting AIs despite price diff. (govt decisions)