Survival with aromatase inhibitors and inactivators versus standard hormonal therapy in advanced breast cancer: Meta-analysis
Ημερομηνία
2006Source
Journal of the National Cancer InstituteVolume
98Issue
18Pages
1285-1291Google Scholar check
Keyword(s):
Metadata
Εμφάνιση πλήρους εγγραφήςΕπιτομή
Background: Aromatase inhibitors and inactivators have been extensively tested in patients with advanced breast cancer, but it is unclear whether they offer any survival benefits compared with standard hormonal treatment with tamoxifen or progestagens. We performed a meta-analysis of randomized controlled trials that compared several generations of aromatase inhibitors and inactivators with standard hormonal treatment in patients with advanced breast cancer. Methods: The endpoint that we assessed was survival. Trials were located through searches of PubMed and Cochrane Library (last update March 2006). Relative hazards (RHs) were summarized across trials through fixed- and random-effects analyses, and heterogeneity was assessed with the Q and I2 statistics. All statistical tests were two-sided. Results: Twenty-five different comparisons, with a total of 8504 patients, were included in the meta-analysis. We found statistically significant survival benefits with third-generation aromatase inhibitors and inactivators (vorozole, letrozole, examestane, and anastrazole) (RH = 0.87, 95% confidence interval [CI] = 0.82 to 0.93; P<.001) but not with first-generation (aminoglutethimide) or second-generation (formestane and fadrozole) agents. The difference in the summary effects between these two groups of trials was statistically significant (P = .04). The survival benefit with third-generation agents in first-line trials, in which these agents were compared with tamoxifen (11% RH reduction, 95% CI = 1% to 19%; P = .03), was identical to their benefit in second- and subsequent-line trials in which these agents were compared with other treatments (14% RH reduction, 95% CI = 6% to 21%; P<.001). Conclusions: Inhibition of the aromatase system, in particular with third-generation aromatase inhibitors and inactivators, appears to be associated with statistically significant improved survival of patients with advanced breast cancer compared with standard hormonal treatments. © 2006 Oxford University Press.
Collections
Cite as
Related items
Showing items related by title, author, creator and subject.
-
Article
Randomized evidence on chemotherapy and hormonal therapy regimens for advanced endometrial cancer: An overview of survival data
Polyzos, N. P.; Pavlidis, Nicholas; Paraskevaidis, E.; Ioannidis, J. P. A. (2006)Several chemotherapy and hormonal therapy regimens have been used in advanced endometrial cancer. In this review we have systematically evaluated the available data from randomized trials on survival. We searched MEDLINE, ...
-
Article
Gene expression of estrogen receptor, progesterone receptor and microtubule-associated protein Tau in high-risk early breast cancer: A quest for molecular predictors of treatment benefit in the context of a Hellenic Cooperative Oncology Group trial
Pentheroudakis, George; Kalogeras, K. T.; Wirtz, R. M.; Grimani, I.; Zografos, G.; Gogas, H.; Stropp, U.; Pectasides, Dimitrios; Skarlos, Dimosthenis V.; Hennig, G.; Samantas, E.; Bafaloukos, Dimitrios; Papakostas, P.; Kalofonos, H. P.; Pavlidis, Nicholas; Fountzilas, George (2009)Background Estrogen receptor (ER) and progesterone receptor (PgR) protein expression carry weak prognostic and moderate predictive utility for the outcome of early breast cancer patients on adjuvant chemohormonotherapy. ...
-
Article
Metastatic breast cancer with liver metastases: A registry analysis of clinicopathologic, management and outcome characteristics of 500 women
Pentheroudakis, George; Fountzilas, George; Bafaloukos, Dimitrios; Koutsoukou, V.; Pectasides, Dimitrios; Skarlos, Dimosthenis V.; Samantas, E.; Kalofonos, H. P.; Gogas, H.; Pavlidis, Nicholas (2006)Introduction. Breast cancer patients developing liver metastases have traditionally been considered to make up a poor prognosis group with median survival rates of less than 6 months. We retrospectively analysed clinicopathologic ...