• Title, Summary, Keyword: anastrozole

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Fulvestrant 250mg versus Anastrozole 1 mg in the Treatment of Advanced Breast Cancer: a Meta-Analysis of Randomized Controlled Trials

  • Gong, Dan-Dan;Man, Chang-Feng;Xu, Juan;Fan, Yu
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.5
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    • pp.2095-2100
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    • 2014
  • Objective: Most patients with advanced breast cancer experience resistance to endocrine treatment and eventual disease progression. This meta-analysis was designed to compare the efficacy and tolerability of fulvestrant 250mg with anastrozole 1mg in postmenopausal women with advanced breast cancer. Methods: Electronic literature databases (Cochrane Library, Medline, and Embase) were searched for randomized controlled trials (RCTs) published prior to August 2013. Only RCTs that compared fulvestrant 250mg to anastrozole 1mg in postmenopausal women with advanced breast cancer were selected. The main outcomes were time to treatment failure (TTF), time to progression (TTP), duration of response (DOR), clinical benefit rate, and tolerability. Results: Four RCTs covering 1,226 patients (fulvestrant, n=621; anastrozole, n=605) were included in the meta-analysis. Fulvestrant increased the DOR compared to anastrozole (HR =1.31, 95% confidence interval [CI] 1.13-1.51). There was no statistically significant difference between fulvestrant and anastrozole in terms of TTF (HR=1.02, 95%CI 0.89-1.17), complete response (RR=1.79, 95%CI, 0.93-3.43), and partial response (RR=0.91, 95%CI 0.69-1.21). As for safety, there was no statistical significance between the two groups for common adverse events. Conclusion: Fulvestrant 250mg is as effective and well-tolerated as anastrozole 1mg treatment for advanced breast cancer in postmenopausal women whose disease progressed after prior endocrine treatment. Thus, fulvestrant may serve as a reasonable alternative to anastrozole when resistance is experienced in breast cancer cases.

The Effectiveness of Aromatase Inhibitor in Infertile Male (불임남성에서 방향화효소 억제제의 치료 효과)

  • Lee, Jae-Seok;Han, Keo-Reum;Park, Young-Seog;Seo, Ju-Tae
    • Clinical and Experimental Reproductive Medicine
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    • v.30 no.2
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    • pp.135-139
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    • 2003
  • Objective: We investigated whether serum testosterone to estradiol ratio was decreased in infertile men and whether this condition can be corrected with oral aromatase inhibitor. Method: The serum testosterone to estradiol ratio of 26 men with testicular failure were compared with those of normal semen analysis parameter, 89 control reference group. All of 26 testicular failure group were diagnosed with the previous testicular biopsy. Then 46 men with oligospermia and/or asthenospermia were selected and treated with 1 mg of the aromatase inhibitor anastrozole ($Arimidex^{(R)}$) orally once daily for 3 months. Testosterone to estradiol ratio and semen analyses were evaluated during anastrozole therapy. Results: The testosterone level of testicular failure group was significantly lower and the testosterone to estradiol ratio was more decreased than normal semen parameter group. Forty six on-anastrozole group had significantly lower testosterone (4.6 versus 5.7 ng/ml, p<0.01) and higher estradiol (15.9 versus 23.4 pg/ml, p<0.01) than pre-anastrozole group, resulting in a decreased testosterone to estradiol ratio ($0.21{\pm}0.07$ versus $0.39{\pm}0.15$, p<0.01). Semen analyses before and during anastrozole treatment revealed significant increases in sperm count (35.5 versus 52.2 million sperm per ml, p<0.01) and motility (22.9% versus 29.3%, p<0.01). Conclusions: We identified infertile men with testicular failure had hormonal changes characterized by a decreased serum testosterone to estradiol ratio. The ratio can be corrected with aromatase inhibitor, resulting in a significant improvement in semen parameters.

Efficacy and Safety of Trastuzumab Added to Standard Treatments for HER2-positive Metastatic Breast Cancer Patients

  • Zhu, Zhen-Li;Zhang, Jun;Chen, Mei-Lan;Li, Ke
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.12
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    • pp.7111-7116
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    • 2013
  • Introduction: Trastuzumab, an HER2-targeting agents, has shown efficacy in metastatic HER2-positive breast cancer patients. Single-agent clinical trials have evaluated therapeutic regimens using trastuzumab for metastatic breast cancer patients. The aim of our study is to evaluate the efficacy and safety of trastuzumab in combination with chemotherapy or hormone therapy in HER2-positive metastatic breast cancer patients. Methods: A literature research was conducted in PubMed and to identify appropriate studies from relevant reviews. Randomized controlled trials comparing chemotherapy or hormone therapy regimens in combination with trastuzumab were eligible. Dadta on clinical outcomes, including safety, efficacy, and patient characteristics were collected. Results: Seven articles describing five trials were included in our systematic review and meta-analysis. Partners of trastuzumab included in trials were anthracycline, paclitaxel, docetaxel, anastrozole and letrozole. The addition of trastuzumab to chemotherapy improved the overall survival (HR=0.79, 95%CI 0.65-0.96), while to hormone therapy did not (HR=0.85 95%CI 0.56-1.30). All trastuzumab-containing regimens increased cardiac toxicity (RR=3.37, 95%CI 1.26-9.02) and grade III-IV adverse events. Conclusions: Our study supports the addition of trastuzumab to chemotherapy which is effective and tolerated for metastatic breast cancer with HER2+ patients. Of note, more adverse events will occur followed the use of trastuzumab, especially cardiac toxicity, with two treatment regimens.