New generation drugs better for breast cancer than tamoxifen say specialists
An international panel of cancer specialists - including Cancer Research UK's Professor Jack Cuzick - has ruled that a new generation of breast cancer drugs known as aromatase inhibitors (AIs) are even more effective than the previous 'gold standard' drug, tamoxifen.
The panel agreed that AIs were superior to tamoxifen when treating women with early, hormone-sensitive breast cancer and should be the first choice of treatment.
About four out of five women with breast cancer have 'hormone-sensitive', or 'oestrogen receptor positive' cancers.
"This guidance helps to clarify considerations for use of AIs in everyday practice," said panel member professor Aman Buzdar of the MD Anderson Cancer Centre in the US.
"Over the last three years, there has been an influx of new information about the use of AIs in early breast cancer, and while this is great news, it has created a great deal of confusion.
"These data provide the evidence that support using an aromatase inhibitor at the earliest opportunity," he added.
The decision examined the results of several major trials of AIs, showing that there were no patients who did not benefit from treatment with the drugs.
Many of the possible side effects of tamoxifen were substantially reduced with AIs, said the panel, although an increase in the number of bone fractures was noted.
These were predictable and manageable, however. An increase in joint disorders was also noted and AIs relationship to heart disease required further study, it said.
"The data in support of AIs are very strong," added professor Rowan Chlebowski of the US University of California's Medical Centre.
"Although tamoxifen has served us well for over 20 years, if we want to give our patients the most effective and well tolerated treatment for their breast cancer, it's time to consider an AI."
The decision by the 24 breast cancer specialists of the International Aromatase Inhibitor Expert Panel is published in the journal Current Medical Research and Opinion.