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Table 1 Three aims for endocrine therapy Figure 1 Weight gain over time. (Adaptedfrom Buzdar A.U., Howell A., JonesS. et al. (1996)Proc ASCO, 15, Abstract 100.) Megestrol acetate 4 x 40mg (n= 85) a + 9 2 L C C a m IC Anastrozole 1 mg (n = 98) -11 Months from start of therapy + General health + Anti-turnoureffect + Side-effects - maintain well being - prevent flushes/sweats - no weight gain - favourable lipid profile - maintainbone mineral density - advanced - adjuvant - prevention - few or none not yet fully understood and these questions will need to be answered by further research. Most importantly, ArimidexTM does not induce weight gain, unlike megestrol acetate, which in a comparative study resulted in progressive weight gain throughout treatment (see Fig. 1). As weight gain is, for most patients, a very distressing side-effect, the fact that this new agent is not associated with this side-effect is a significant advance. Looking to the future, ATAC (ArimidexTM versus Tamoxifen: Alone or in Combination) is an important clinical trial, currently in progress, that will involve 6000 women randomized to receive ArimidexTM alone, tamoxifen alone or the two agents in combination as an adjuvant treatment. The second recent advance in endocrine therapy involves the development of a pure anti-oestrogen that, unlike tamoxifen, shows no agonist effects and may prolong time between relapses. The results, thus far, are promising with minimal side-effects and little or no adverse effect on general well-being. Further research needs to be carried out to determine effects on bone, but this agent may well have a place in the future treatment of advanced breast cancer. In summary, the new generation aromatase inhibitors have favourable toxicity profiles and are an important new advance in the treatment of breast cancer. Furthermore, the new generation of anti-oestrogen therapies may prove to be more effective and less toxic than standard endocrine therapies, including tamoxifen, although there is considerable research yet to be carried out. However, womenâs general health remains an important consideration,especially as these new agents may be used more widely in adjuvant or preventative situations in the future. ADDITIONAL INFORMATION 1. Buzdar A.U., Jonat W., Howell A., et al. f Clin Oncol, 1996, 14,2000-20 1 1. 2. Howell A., et al. Eur 1 Cancer, 1996,32A, 576-588. ArimidexTMis a trade mark, the property of Zeneca Ltd. 0 1996 Blackwell Science Ltd, European journal of Cancer Care, 5, Supplement 3, 1-12
European Journal of Cancer Care – Wiley
Published: Dec 1, 1996
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