Fulvestrant 500 mg Versus Exemestane in Postmenopausal Women With Metastatic Breast Cancer Resistant to Adjuvant Nonsteroidal Aromatase Inhibitors in Clinical Practice: A Multicenter Retrospective Study

Autor: Rui Ge, Yizhao Xie, Leiping Wang, Yannan Zhao, Wei Li, Yinbin Zhang, Yi Li, Biyun Wang, Xichun Hu, Shuqun Zhang, Chengcheng Gong, Xiaoxiang Guan, Jian Zhang, Enying Cao
Rok vydání: 2019
Předmět:
Adult
0301 basic medicine
Oncology
Cancer Research
medicine.medical_specialty
Receptor
ErbB-2
medicine.drug_class
medicine.medical_treatment
Breast Neoplasms
03 medical and health sciences
chemistry.chemical_compound
0302 clinical medicine
Breast cancer
Exemestane
Internal medicine
Antineoplastic Combined Chemotherapy Protocols
medicine
Humans
Neoplasm Metastasis
Adverse effect
Fulvestrant
Aged
Retrospective Studies
Aged
80 and over
Chemotherapy
Aromatase inhibitor
Aromatase Inhibitors
business.industry
Middle Aged
Prognosis
medicine.disease
Metastatic breast cancer
Androstadienes
Postmenopause
Survival Rate
Clinical trial
030104 developmental biology
Receptors
Estrogen
chemistry
Drug Resistance
Neoplasm
030220 oncology & carcinogenesis
Female
Receptors
Progesterone
business
Follow-Up Studies
medicine.drug
Zdroj: Clinical Breast Cancer. 19:e452-e458
ISSN: 1526-8209
Popis: Background Fulvestrant 500 mg and exemestane are widely used agents in first-line therapy for metastatic breast cancer (MBC) of estrogen receptor (ER)-positive (ER+) postmenopausal MBC after failure of adjuvant nonsteroidal aromatase inhibitor (NSAI) treatment. Although fulvestrant 250 mg had similar efficacy compared with exemestane (Evaluation of Faslodex versus Exemestane Clinical Trial study) and fulvestrant 500 mg was superior to fulvestrant 250 mg (Comparison of FASLODEX In Recurrent or Metastatic Breast Cancer study), no direct comparison between fulvestrant 500 mg and exemestane has been conducted. The aim of this study was to compare the efficacy and safety of fulvestrant 500 mg and exemestane in daily practice. Patients and Methods We retrospectively evaluated the medical records of all patients with ER+ HER2− MBC who received fulvestrant 500 mg or exemestane 25 mg as first-line therapy for MBC from 2015 to 2017 in 4 institutions. A total of 120 patients were available for analysis. Both agents accounted for 50% (60) patients. Results The median progression-free survival (PFS) of the fulvestrant group was significantly longer than that in the exemestane group (6.2 months [95% confidence interval (CI), 5.0-7.4] versus 4.8 months [95% CI, 3.0-6.7], P = .024). In subgroup analysis, for patients with visceral metastasis or primary endocrine resistance, no significant difference considering PFS was observed in the 2 groups (P = .563 and .769). No significant difference of Grade 3/4 adverse events was observed in the 2 groups (3 patients, 5% versus 2 patients, 3.3%; P = .648). Conclusion Fulvestrant 500 mg showed better efficacy than exemestane in first-line therapy for MBC of ER+ postmenopausal women after failure of adjuvant NSAI treatment. For patients with visceral metastasis or primary endocrine resistance, both treatments showed poor outcomes, indicating a need for further alternatives (targeted therapy or chemotherapy). Both agents were well tolerated in terms of toxicities.
Databáze: OpenAIRE
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