Interview
with Neil Love, MD Breast Cancer Update for Medical Oncologists,
Program 6 2000
Play
Audio Below:
The
European trial and the American trial are a little bit different
in their structure and in the results. The American trial, which
I think has a better design – it was a double-blind study.
Patients assigned Arimidex still got the injections of placebo,
but they received an injection. So, it’s clearly blinded also,
because the patients had to come to the clinic once a month –
even if they happened to be assigned to Arimidex – to get their
injection. There is consistency with regard to the patient being
seen.
In
the European trial, it was not a double-blinded trial, and the patients
on Arimidex were seen every three months. The patients on Faslodex,
of course, were seen by someone – it might have been a nurse
– every month. It runs the potential to have some bias there
in terms of identifying when the patient progresses.
Since
the Faslodex group in the European trial is being seen a little
more often, conceivably you would be identifying progressor patients
a little earlier than Arimidex patients. Having said that, the results
in the American trial show that the response rates are about the
same between the two drugs, but in the American trial the response
duration is about twice as long compared to Arimidex.
In
the UK trial, it doesn’t show that. It doesn’t show that
the response duration is longer. So, we have a dilemma. Both of
these were large trials. Why is that? And one hypothesis is that,
"Could it be due to these differences in follow-up of the patients?"
I don’t know whether, statistically, if you identified patients
a month or two earlier, whether that would show up as a change in
response duration that would explain this result. I don’t know
whether that’s the case or not. But we have slightly different
results. We have to keep it in mind, though, aromatase inhibitors
are very good drugs in and of themselves. In one trial, it’s
at least as good as Arimidex. In the other trial, at least in one
parameter that you might have predicted from our model, actually,
that it might take a longer time for resistance to develop in those
tumors that have a response, we see an advantage.
Formestane
is feasible and effective in elderly breast cancer patients with
comorbidity and disability. Venturino,
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Critique
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of Surgical Oncology. 6(8 Suppl S):8S-11S, 1999 Dec. No abstract
Letrozole:
Which dose to be used? Buzdar, A. U. Journal of Clinical Oncology. 18(8):1802-1803,
2000 Apr. No abstract
Similarities
and distinctions in the mode of action of different classes of antioestrogens
[Review]. Wakeling,
A. E. Endocrine-Related Cancer. 7(1):17-28, 2000 Mar. No abstract
Approaches
targeted to estrogen receptors for treatment of tamoxifen-resistant
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Sch Med, Dept Obstet & Gynecol Yonago Tottori 683 Japan)..
Oncology. 59(Suppl 1):3-4, 2000. No abstract
Treatment
with the pure antiestrogen faslodex (ICI 182780) induces tumor necrosis
factor receptor 1 (TNFR1) expression in MCF-7 breast cancer cells. Smolnikar,
K.; Loffek, S.; Schulz, T.; Michna, H., and Diel, P. (Reprint available
from: Smolnikar K DSHS Cologne, Inst Morphol & Tumor Res Carl
Diem Weg 6 D-50927 Cologne Germany). Breast Cancer Research &
Treatment. 63(3):249-259, 2000 Oct. In process
Symposium
overview: Estrogens and antiestrogens in managing the patient with
breast cancer. Newman,
L. A.; Wood, W. C.; Sellin, R. V.; Morrow, M.; Vogel, C., and Singletary,
S. E (Reprint available from: Singletary SE Univ Texas, MD Anderson
Canc Ctr, Dept Surg Oncol 1515 Holcombe Blvd,Box 106 Houston, TX
77030 USA).. Annals of Surgical Oncology. 7(8):568-574, 2000 Sep.
In process
