Breast Cancer Drug Therapy Combinations Compared

Sequential treatment with tamoxifen and letrozole shows no improvement over letrozole alone

WEDNESDAY, Aug. 19 (HealthDay News) -- Disease-free survival does not improve in women with breast cancer treated with tamoxifen and letrozole sequentially compared with letrozole alone, according to a study in the Aug. 20 issue of the New England Journal of Medicine.

Henning Mouridsen, M.D., from Vejle Hospital in Copenhagen, Denmark, and colleagues randomly assigned 6,182 postmenopausal women with hormone receptor-positive breast cancer to five years of letrozole alone, five years of tamoxifen alone, or two years of one drug followed by three years of the other drug. The analysis of each drug alone included an additional randomly assigned group for a total of 4,922 women receiving letrozole or tamoxifen alone.

After a median follow-up of 71 months, compared with letrozole alone, the researchers found no significant improvement in disease-free survival for either group receiving tamoxifen and letrozole sequentially. Women receiving tamoxifen followed by letrozole had more early relapses than women receiving letrozole alone. Overall survival was not significantly different among women taking tamoxifen or letrozole alone.

"Among postmenopausal women with endocrine-responsive breast cancer, sequential treatment with letrozole and tamoxifen, as compared with letrozole monotherapy, did not improve disease-free survival," Mouridsen and colleagues conclude. "The difference in overall survival with letrozole monotherapy and tamoxifen monotherapy was not statistically significant."

The study was supported by Novartis, and many authors reported financial and consulting relationships with pharmaceutical companies.

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