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Survival Advantage of Anastrozole Over Tamoxifen Seen in Meta Analysis: Presented at SABCS

By Ed Susman

SAN ANTONIO, TX -- December 12, 2005 -- For the first time, doctors say that switching a breast cancer patient from the gold standard tamoxifen to the aromatase inhibitor anastrozole (Arimidex) can save women's lives.

"To women with breast cancer, survival is the most important outcome," said Walter Jonat, MD, director, obstetrics and gynecology clinic, University of Kiel, Kiel, Germany. "If we use the right drugs we will save lives."

He said that a meta-analysis of 3 major studies indicated that women taking Arimidex rather than tamoxifen had a 29% improvement in overall survival. The reduction proved to be statistically significant at the P = .038 level.

The analysis also found a 39% improvement in distant recurrence-free survival and a 45% improvement in event-free survival in women on Arimidex, Dr. Jonat said.

Dr. Jonat and colleagues analyzed the results of the Italian Tamoxifen Anastrozole trial, the ARNO 95 trial, and the Austrian Breast and Colorectal Cancer Study Group Trial 9.

In the three studies, 1997 women were randomized to treatment with tamoxifen and 2009 women to anastrozole. The women in the trial had been diagnosed with early-stage hormone-sensitive breast cancer. All were postmenopausal.

In the intention-to-treat analysis in the 3 studies, 90 women who were taking tamoxifen died -- about 4.5% of the total treated with that drug. There were 66 deaths among the women who were assigned anastrozole -- about 3.3% of the total treated with that drug.

"For the first time we have shown that we have a statistically significant benefit in survival by switching patients from tamoxifen to anastrozole," Dr. Jonat said at a press briefing on December 9^th at the 28^th Annual San Antonio Breast Cancer Symposium (SABCS).

He noted that the meta-analysis also demonstrated a benefit in outcomes with anastrozole when looking at local recurrences, distant recurrences, or appearance of cancer in the contralateral breast.

"Our results make it possible for us to say that 5 years of tamoxifen is no longer the gold standard for these women," he said.


[Presentation title: Switching from Adjuvant Tamoxifen to Anastrozole in Postmenopausal Women With Hormone-Responsive Early Breast Cancer: a Meta-Analysis of the ARNO 95 Trial, ABCSG Trial 8, and the ITA Trial. Abstract 18]

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