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dc.contributor.authorRobertson, John F R
dc.contributor.authorHowell, Anthony
dc.contributor.authorGorbunova, V A
dc.contributor.authorWatanabe, Toru
dc.contributor.authorPienkowski, Tadeusz
dc.contributor.authorLichinitser, M R
dc.date.accessioned2009-07-29T14:22:23Z
dc.date.available2009-07-29T14:22:23Z
dc.date.issued2005-07
dc.identifier.citationSensitivity to further endocrine therapy is retained following progression on first-line fulvestrant. 2005, 92 (2):169-74 Breast Cancer Res. Treat.en
dc.identifier.issn0167-6806
dc.identifier.pmid15986127
dc.identifier.doi10.1007/s10549-004-4776-0
dc.identifier.urihttp://hdl.handle.net/10541/75868
dc.description.abstractThere is a need for new endocrine agents that lack cross-resistance with currently available treatments to extend the endocrine treatment window and delay the need for cytotoxic chemotherapy. This retrospective analysis evaluated the response of postmenopausal patients with previously untreated metastatic/locally advanced breast cancer to further endocrine treatment following progression on first-line fulvestrant or tamoxifen. Patients received fulvestrant 250 mg (intramuscular injection every 28 days) plus matching tamoxifen placebo (once daily), or tamoxifen 20 mg (orally once daily) plus matching fulvestrant placebo (every 28 days) in a double-blind, randomized, phase III trial. Treatment continued until disease progression or withdrawal, when further endocrine therapy was initiated (at the treating physician's discretion). Information regarding subsequent therapies and responses was obtained by follow-up questionnaire. Two-hundred-and-forty-five questionnaires were returned (from 587 patients), 149 of which yielded follow-up data on patients receiving second-line endocrine therapy following fulvestrant (n=83) and tamoxifen (n=66). Second-line therapy produced objective responses (OR) in 6/44 (13.6%) and clinical benefit (CB) in 25/44 (56.8%) patients who had CB with fulvestrant and produced OR in 5/41 (12.2%) patients and CB in 27/41 (65.8%) patients who had CB with first-line tamoxifen. For patients deriving no CB from trial therapy, second-line therapy produced OR in 3/39 (7.7%) and CB in 15/39 (38.5%) patients in the fulvestrant group and OR in 4/25 (16.0%) and CB in 12/25 (48.0%) patients in the tamoxifen group. Results from this questionnaire-based study suggest that postmenopausal women with advanced breast cancer who respond to first-line fulvestrant or tamoxifen retain sensitivity to subsequent endocrine therapy.
dc.language.isoenen
dc.subjectBreast Canceren
dc.subjectCancer Metastasisen
dc.subject.meshAdult
dc.subject.meshAged
dc.subject.meshAntineoplastic Agents, Hormonal
dc.subject.meshAromatase Inhibitors
dc.subject.meshBreast Neoplasms
dc.subject.meshDrug Resistance, Neoplasm
dc.subject.meshEstradiol
dc.subject.meshFemale
dc.subject.meshHumans
dc.subject.meshMedroxyprogesterone 17-Acetate
dc.subject.meshMegestrol Acetate
dc.subject.meshMiddle Aged
dc.subject.meshNeoplasm Metastasis
dc.subject.meshPostmenopause
dc.subject.meshRetrospective Studies
dc.subject.meshSalvage Therapy
dc.subject.meshTamoxifen
dc.subject.meshTreatment Outcome
dc.titleSensitivity to further endocrine therapy is retained following progression on first-line fulvestrant.en
dc.typeArticleen
dc.contributor.departmentUnit of Surgery, City Hospital, NG5 1PB, Nottingham, UK. John.Robertson@nottingham.ac.uken
dc.identifier.journalBreast Cancer Research and Treatmenten
html.description.abstractThere is a need for new endocrine agents that lack cross-resistance with currently available treatments to extend the endocrine treatment window and delay the need for cytotoxic chemotherapy. This retrospective analysis evaluated the response of postmenopausal patients with previously untreated metastatic/locally advanced breast cancer to further endocrine treatment following progression on first-line fulvestrant or tamoxifen. Patients received fulvestrant 250 mg (intramuscular injection every 28 days) plus matching tamoxifen placebo (once daily), or tamoxifen 20 mg (orally once daily) plus matching fulvestrant placebo (every 28 days) in a double-blind, randomized, phase III trial. Treatment continued until disease progression or withdrawal, when further endocrine therapy was initiated (at the treating physician's discretion). Information regarding subsequent therapies and responses was obtained by follow-up questionnaire. Two-hundred-and-forty-five questionnaires were returned (from 587 patients), 149 of which yielded follow-up data on patients receiving second-line endocrine therapy following fulvestrant (n=83) and tamoxifen (n=66). Second-line therapy produced objective responses (OR) in 6/44 (13.6%) and clinical benefit (CB) in 25/44 (56.8%) patients who had CB with fulvestrant and produced OR in 5/41 (12.2%) patients and CB in 27/41 (65.8%) patients who had CB with first-line tamoxifen. For patients deriving no CB from trial therapy, second-line therapy produced OR in 3/39 (7.7%) and CB in 15/39 (38.5%) patients in the fulvestrant group and OR in 4/25 (16.0%) and CB in 12/25 (48.0%) patients in the tamoxifen group. Results from this questionnaire-based study suggest that postmenopausal women with advanced breast cancer who respond to first-line fulvestrant or tamoxifen retain sensitivity to subsequent endocrine therapy.


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