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Fulvestrant (Faslodex) Effective in Breast Cancer Patients Who Fail Previous Endocrine Therapy: Presented at ASBD

By Steve Carrell

DALLAS, TX -- April 14, 2003 -- Fulvestrant (Faslodex) treatment does not preclude achieving benefit from subsequent endocrine agents such as tamoxifen and aromatase inhibitors, said Virginia Borges, MD, an assistant professor in the medical oncology division at University of Colorado Cancer Center in Aurora.

In addition to potential clinical benefits for patients, this finding is important because patients hate to hear they are hormone resistant and must start chemotherapy. That news is almost as traumatic as hearing they have metastatic breast cancer, Dr. Borges said here April 12^th at the American Society of Breast Disease Annual Symposium.

Fulvestrant is an estrogen receptor (ER) antagonist that downregulates the ER and has no known agonist activity.

Dr. Borges conducted a retrospective study to sequence data from 3 large trials comparing fulvestrant with anastrozole (Arimidex) or tamoxifen. The large studies, published in the Journal of Clinical Oncology in 2002, showed fulvestrant to be effective treatment for postmenopausal women whose disease progressed on tamoxifen.

Dr. Borges' new data cover patients with hormone-sensitive or locally advanced breast cancer that progressed after fulvestrant alone or tamoxifen followed by fulvestrant. She asked investigators about responses among patients who received further endocrine therapy after progression.

Among patients who received fulvestrant alone and achieved clinical benefit but then progressed, 30 then took an aromatase inhibitor, and 15 of them achieved a clinical benefit.

In the other group, patients took tamoxifen, progressed, and then took fulvestrant. Among the 54 patients who achieved clinical benefit from fulvestrant but progressed again, 19 of 46 achieved a clinical benefit from subsequently taking an aromatase inhibitor. Among patients who took megestrol acetate instead, 6 of 8 achieved clinical benefit.

Joyce O'Shaughnessy, MD, who co-moderated the discussion of Borges' poster, said this fascinating study likely will change the way she practices, because she will be more willing to give further endocrine agents after one fails. Dr. O'Shaughnessy is Co-director, Breast Cancer Research, U.S. Oncology.


[Study title: Response to Further Endocrine Therapy After Progression on Fulvestrant (Faslodex). Poster 15]

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