Clinical and economic benefits of aromatase inhibitor therapy in early-stage breast cancer

Stefan Glück, Fariborz Gorouhi

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Purpose. The clinical and economic benefits of aromatase inhibitor (AI) therapy in early-stage breast cancer are reviewed. Summary. AI therapy has become a standard of care for the treatment of most postmenopausal women with early-stage breast cancer, as it significantly reduces the risk of disease recurrence and death. Using the currently accepted gold standard for clinical efficacy - improvement in disease-free survival rather than overall survival - exemestane, anastrozole, or letrozole as monotherapy or in sequence with tamoxifen has been found to be superior to tamoxifen monotherapy. Emerging data have demonstrated potential overall survival advantages for AIs subsequent to and directly related to distant recurrence. Of the nonsteroidal AIs, letrozole appears to have the efficacy advantage by demonstrating an early effect on distant recurrence and, subsequently, a potentially significant overall survival benefit, though results of a prospective head-to-head trial of anastrozole and letrozole are not yet available. When the economic burden to society is considered, it appears that all AIs are similarly beneficial on the basis of disease recurrence. However, preliminary analyses indicate that the survival benefit appears to be greater with letrozole than with anastrozole. Thus, considering potential survival benefits and cost-effectiveness, letrozole may be preferable to anastrozole in the early adjuvant setting. Conclusion. AI therapy has become a standard of care for the treatment of most postmenopausal women with early-stage breast cancer. Emerging data have demonstrated potential overall survival advantages for AIs subsequent to and directly related to distant recurrence. When the economic burden to society is considered, it appears that all AIs are similarly beneficial on the basis of disease recurrence.

Original languageEnglish
Pages (from-to)1699-1706
Number of pages8
JournalAmerican Journal of Health-System Pharmacy
Volume68
Issue number18
DOIs
StatePublished - Sep 15 2011
Externally publishedYes

Fingerprint

letrozole
Aromatase Inhibitors
Economics
Breast Neoplasms
Recurrence
Survival
exemestane
Tamoxifen
Standard of Care
Cost-Benefit Analysis
Therapeutics
Survival Analysis
Disease-Free Survival

Keywords

  • Anastrozole
  • Antineoplastic agents
  • Aromatase inhibitors
  • Breast neoplasms
  • Exemestane
  • Letrozole
  • Mechanism of action
  • Pharmacoeconomics
  • Postmenopause
  • Tamoxifen

ASJC Scopus subject areas

  • Pharmacology
  • Health Policy

Cite this

Clinical and economic benefits of aromatase inhibitor therapy in early-stage breast cancer. / Glück, Stefan; Gorouhi, Fariborz.

In: American Journal of Health-System Pharmacy, Vol. 68, No. 18, 15.09.2011, p. 1699-1706.

Research output: Contribution to journalArticle

@article{6ceeed71d6c74a11ba39ea9ff2abd385,
title = "Clinical and economic benefits of aromatase inhibitor therapy in early-stage breast cancer",
abstract = "Purpose. The clinical and economic benefits of aromatase inhibitor (AI) therapy in early-stage breast cancer are reviewed. Summary. AI therapy has become a standard of care for the treatment of most postmenopausal women with early-stage breast cancer, as it significantly reduces the risk of disease recurrence and death. Using the currently accepted gold standard for clinical efficacy - improvement in disease-free survival rather than overall survival - exemestane, anastrozole, or letrozole as monotherapy or in sequence with tamoxifen has been found to be superior to tamoxifen monotherapy. Emerging data have demonstrated potential overall survival advantages for AIs subsequent to and directly related to distant recurrence. Of the nonsteroidal AIs, letrozole appears to have the efficacy advantage by demonstrating an early effect on distant recurrence and, subsequently, a potentially significant overall survival benefit, though results of a prospective head-to-head trial of anastrozole and letrozole are not yet available. When the economic burden to society is considered, it appears that all AIs are similarly beneficial on the basis of disease recurrence. However, preliminary analyses indicate that the survival benefit appears to be greater with letrozole than with anastrozole. Thus, considering potential survival benefits and cost-effectiveness, letrozole may be preferable to anastrozole in the early adjuvant setting. Conclusion. AI therapy has become a standard of care for the treatment of most postmenopausal women with early-stage breast cancer. Emerging data have demonstrated potential overall survival advantages for AIs subsequent to and directly related to distant recurrence. When the economic burden to society is considered, it appears that all AIs are similarly beneficial on the basis of disease recurrence.",
keywords = "Anastrozole, Antineoplastic agents, Aromatase inhibitors, Breast neoplasms, Exemestane, Letrozole, Mechanism of action, Pharmacoeconomics, Postmenopause, Tamoxifen",
author = "Stefan Gl{\"u}ck and Fariborz Gorouhi",
year = "2011",
month = "9",
day = "15",
doi = "10.2146/ajhp100492",
language = "English",
volume = "68",
pages = "1699--1706",
journal = "American Journal of Health-System Pharmacy",
issn = "1079-2082",
publisher = "American Society of Health-Systems Pharmacy",
number = "18",

}

TY - JOUR

T1 - Clinical and economic benefits of aromatase inhibitor therapy in early-stage breast cancer

AU - Glück, Stefan

AU - Gorouhi, Fariborz

PY - 2011/9/15

Y1 - 2011/9/15

N2 - Purpose. The clinical and economic benefits of aromatase inhibitor (AI) therapy in early-stage breast cancer are reviewed. Summary. AI therapy has become a standard of care for the treatment of most postmenopausal women with early-stage breast cancer, as it significantly reduces the risk of disease recurrence and death. Using the currently accepted gold standard for clinical efficacy - improvement in disease-free survival rather than overall survival - exemestane, anastrozole, or letrozole as monotherapy or in sequence with tamoxifen has been found to be superior to tamoxifen monotherapy. Emerging data have demonstrated potential overall survival advantages for AIs subsequent to and directly related to distant recurrence. Of the nonsteroidal AIs, letrozole appears to have the efficacy advantage by demonstrating an early effect on distant recurrence and, subsequently, a potentially significant overall survival benefit, though results of a prospective head-to-head trial of anastrozole and letrozole are not yet available. When the economic burden to society is considered, it appears that all AIs are similarly beneficial on the basis of disease recurrence. However, preliminary analyses indicate that the survival benefit appears to be greater with letrozole than with anastrozole. Thus, considering potential survival benefits and cost-effectiveness, letrozole may be preferable to anastrozole in the early adjuvant setting. Conclusion. AI therapy has become a standard of care for the treatment of most postmenopausal women with early-stage breast cancer. Emerging data have demonstrated potential overall survival advantages for AIs subsequent to and directly related to distant recurrence. When the economic burden to society is considered, it appears that all AIs are similarly beneficial on the basis of disease recurrence.

AB - Purpose. The clinical and economic benefits of aromatase inhibitor (AI) therapy in early-stage breast cancer are reviewed. Summary. AI therapy has become a standard of care for the treatment of most postmenopausal women with early-stage breast cancer, as it significantly reduces the risk of disease recurrence and death. Using the currently accepted gold standard for clinical efficacy - improvement in disease-free survival rather than overall survival - exemestane, anastrozole, or letrozole as monotherapy or in sequence with tamoxifen has been found to be superior to tamoxifen monotherapy. Emerging data have demonstrated potential overall survival advantages for AIs subsequent to and directly related to distant recurrence. Of the nonsteroidal AIs, letrozole appears to have the efficacy advantage by demonstrating an early effect on distant recurrence and, subsequently, a potentially significant overall survival benefit, though results of a prospective head-to-head trial of anastrozole and letrozole are not yet available. When the economic burden to society is considered, it appears that all AIs are similarly beneficial on the basis of disease recurrence. However, preliminary analyses indicate that the survival benefit appears to be greater with letrozole than with anastrozole. Thus, considering potential survival benefits and cost-effectiveness, letrozole may be preferable to anastrozole in the early adjuvant setting. Conclusion. AI therapy has become a standard of care for the treatment of most postmenopausal women with early-stage breast cancer. Emerging data have demonstrated potential overall survival advantages for AIs subsequent to and directly related to distant recurrence. When the economic burden to society is considered, it appears that all AIs are similarly beneficial on the basis of disease recurrence.

KW - Anastrozole

KW - Antineoplastic agents

KW - Aromatase inhibitors

KW - Breast neoplasms

KW - Exemestane

KW - Letrozole

KW - Mechanism of action

KW - Pharmacoeconomics

KW - Postmenopause

KW - Tamoxifen

UR - http://www.scopus.com/inward/record.url?scp=80053072192&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=80053072192&partnerID=8YFLogxK

U2 - 10.2146/ajhp100492

DO - 10.2146/ajhp100492

M3 - Article

VL - 68

SP - 1699

EP - 1706

JO - American Journal of Health-System Pharmacy

JF - American Journal of Health-System Pharmacy

SN - 1079-2082

IS - 18

ER -