Aromatase inhibitors in breast cancer

New England Journal of Medicine

Volumn 348, Issue 24, 2003, Pages 2431-2442

  Smith, Ian E ^a   Dowsett, Mitch ^b  

^a ROYAL MARSDEN HOSPITAL   (United Kingdom)

^b NONE

Author keywords

[No Author keywords available]

Indexed keywords

AMINOGLUTETHIMIDE; ANASTROZOLE; ANDROSTENEDIONE; AROMATASE INHIBITOR; ESTROGEN; ESTROGEN RECEPTOR; EXEMESTANE; FADROZOLE; FORMESTANE; LETROZOLE; MEGESTROL ACETATE; PYRIDOGLUTETHIMIDE; TAMOXIFEN; VOROZOLE;

ADRENAL INSUFFICIENCY; ADVANCED CANCER; ALDOSTERONE RELEASE; BONE DEMINERALIZATION; BRAIN ISCHEMIA; BREAST CANCER; CANCER ADJUVANT THERAPY; CANCER INCIDENCE; CANCER SURVIVAL; CATARACT; CELL STRAIN MCF 7; CHEMOPROPHYLAXIS; DEEP VEIN THROMBOSIS; DRUG HALF LIFE; DRUG MECHANISM; DRUG STRUCTURE; ENDOMETRIUM CANCER; ESTROGEN RELEASE; FATIGUE; FRACTURE; HORMONE SUBSTITUTION; HOT FLUSH; HUMAN; ISCHEMIC HEART DISEASE; MOOD DISORDER; MUSCULOSKELETAL DISEASE; NAUSEA AND VOMITING; POSTMENOPAUSE; PREMENOPAUSE; PRIORITY JOURNAL; REVIEW; VAGINA BLEEDING; VAGINA DISCHARGE; VEIN THROMBOSIS;

ANDROSTENEDIONE; ANTINEOPLASTIC AGENTS; AROMATASE; AROMATASE INHIBITORS; BREAST NEOPLASMS; CHEMOTHERAPY, ADJUVANT; DRUG THERAPY, COMBINATION; ENZYME INHIBITORS; FEMALE; HUMANS; PREMENOPAUSE;

EID: 0038210242     PISSN: 00284793     EISSN: None     Source Type: Journal    
DOI: 10.1056/NEJMra023246     Document Type: Review

References (105)

1. Ingle JN, Ahmann DL, Green SJ, et al. Randomized clinical trial of diethylstilbestrol versus tamoxifen in postmenopausal women with advanced breast cancer. N Engl J Med 1981;304:16-21.
2. Muss HB, Wells HB, Paschold EH, et al. Megestrol acetate versus tamoxifen in advanced breast cancer: 5-year analysis - a phase III trial of the Piedmont Oncology Association. J Clin Oncol 1988;6:1098-106.
3. Gill PG, Gebski V, Snyder R, et al. Randomized comparison of the effects of tamoxifen, megestrol acetate, or tamoxifen plus megestrol acetate on treatment response and survival in patients with metastatic breast cancer. Ann Oncol 1993;4:741-4.
4. Muss HB, Case LD, Atkins JN, et al. Tamoxifen versus high-dose oral medroxyprogesterone acetate as initial endocrine therapy for patients with metastatic breast cancer: a Piedmont Oncology Association study. J Clin Oncol 1994;12:1630-8.
5. Kellokumpu-Lehtinen P, Huovinen R, Johansson R. Hormonal treatment of advanced breast cancer: a randomized trial of tamoxifen versus nandrolone decanoate. Cancer 1987;60:2376-81.
6. Hayes DF, Van Zyl JA, Hacking A, et al. Randomized comparison of tamoxifen and two separate doses of toremifene in post-menopausal patients with metastatic breast cancer. J Clin Oncol 1995;13:2556-66.
7. Stenbygaard LE, Herrstedt J, Thomsen JF, Svendsen KR, Engelholm SA, Dombernowsky P. Toremifene and tamoxifen in advanced breast cancer - a double-blind cross-over trial. Breast Cancer Res Treat 1993;25:57-63.
8. Smith IE, Harris AL, Morgan M, et al. Tamoxifen versus aminoglutethimide in advanced breast carcinoma: a randomised cross-over trial. Br Med J (Clin Res Ed) 1981; 283:1432-4.
9. Lipton A, Harvey HA, Santen RJ, et al. A randomised trial of aminoglutethimide versus tamoxifen in metastatic breast cancer. Cancer 1982;50:2265-8.
10. Gale KE, Andersen JW, Tormey DC, et al. Hormonal treatment for metastatic breast cancer: an Eastern Cooperative Oncology Group Phase III trial comparing aminoglutethimide to tamoxifen. Cancer 1994;73: 354-61.
11. Falkson CI, Falkson HC. A randomised study of CGS 16949A (fadrozole) versus tamoxifen in previously untreated postmenopausal patients with metastatic breast cancer. Ann Oncol 1996;7:465-9.
12. Thurlimann B, Beretta K, Bacchi M, et al. First-line fadrozole HCI (CGS 16949A) versus tamoxifen in postmenopausal women with advanced breast cancer: prospective randomised trial of the Swiss Group for Clinical Cancer Research SAKK 20188. Ann Oncol 1996;7:471-9.
13. Early Breast Cancer Trialists' Collaborative Group. Tamoxifen for early breast cancer: an overview of the randomised trials. Lancet 1998;351:1451-67.
14. Fisher B, Costantino JP, Wickerham DL, et al. Tamoxifen for prevention of breast cancer: report of the National Surgical Adjuvant Breast and Bowel Project P-1 Study. J Natl Cancer Inst 1998;90:1371-88.
15. IBIS investigators. First results from the International Breast Cancer Intervention Study (IBIS-I): a randomised prevention trial. Lancet 2002;360:817-24.
16. Goss PE, Strasser K. Aromatase inhibitors in the treatment and prevention of breast cancer. J Clin Oncol 2001;19:881-94.
17. Buzdar A, Howell A. Advances in aromatase inhibition: clinical efficacy and tolerability in the treatment of breast cancer. Clin Cancer Res 2001;7:2620-35.
18. Beatson GT. On the treatment of inoperable cases of carcinoma of the mamma: suggestions for a new method of treatment, with illustrative cases. Lancet 1896;2:104-7.
19. Howell A, Dowsett M. Recent advances in endocrine therapy of breast cancer. BMJ 1997;315:863-6.
20. Powles TJ, Hickish T, Kanis JA, Tidy A, Ashley S. Effect of tamoxifen on bone mineral density measured by dual-energy x-ray absorptiometry in healthy premenopausal and postmenopausal women. J Clin Oncol 1996;14:78-84.
21. Love RR, Barden HS, Mazess RB, Epstein S, Chappell RJ. Effect of tamoxifen on lumbar spine bone mineral density in postmenopausal women after 5 years. Arch Intern Med 1994;154:2585-8.
22. Tamoxifen and endometrial cancer. ACOG committee opinion. No. 232. Washington, D.C.: American College of Obstetricians and Gynecologists, 2000.
23. DeFriend DJ, Anderson E, Bell J, et al. Effects of 4-hydroxytamoxifen and a novel pure antioestrogen (ICI 182780) on the clonogenic growth of human breast cancer cells in vitro. Br J Cancer 1994;70:204-11.
24. Evans CT, Ledesma DB, Schulz TZ, Simpson ER, Mendelson CR. Isolation and characterization of a complementary DNA specific for human aromatase-system cytochrome P-450 mRNA. Proc Natl Acad Sci U S A 1986;83:6387-91.
25. Miller WR, Hawkins RA, Forrest AP. Significance of aromatase activity in human breast cancer. Cancer Pes 1982;42:Suppl: 3365s-3368s.
26. Nelson LR, Bulun SE. Estrogen production and action. J Am Acad Dermatol 2001; 45:Suppl:S116-S124.
27. Longcope C, Baker R, Johnston CC Jr. Androgen and estrogen metabolism: relationship to obesity. Metabolism 1986;35: 235-7.
28. Thijssen JH, Blankenstein MA. Endogenous oestrogens and androgens in normal and malignant endometrial and mammary tissues. Eur J Cancer Clin Oncol 1989;25: 1953-9.
29. Miller WR, O'Neill J. The importance of local synthesis of estrogen within the breast. Steroids 1987;50:537-48.
30. Simpson ER, Clyne C, Rubin G, et al. Aromatase - a brief overview. Annu Rev Physiol 2002;64:93-127.
31. Simpson ER, Dowsett M. Aromatase and its inhibitors: significance for breast cancer therapy. Recent Prog Horm Res 2002;57:317-38.
32. Sinha S, Kaseta J, Santner SJ, Demers LM, Bremmer WJ, Santen RJ. Effect of CGS 20267 on ovarian aromatase and gonadotropin levels in the rat. Breast Cancer Res Treat 1998;48:45-51.
33. Stein RC, Dowsett M, Hedley A, Gazet JC, Ford HT, Coombes RC. The clinical and endocrine effects of 4-hydroxyandrostenedione alone and in combination with goserelin in premenopausal women with advanced breast cancer. Br J Cancer 1990;62: 679-83.
34. Mitwally MF, Casper RF. Aromatase inhibition for ovarian stimulation: future avenues for infertility management. Curr Opin Obstet Gynecol 2002;14:255-63.
35. Santen RJ, Samojlik E, Lipton A, et al. Kinetic, hormonal and clinical studies with aminoglutethimide in breast cancer. Cancer 1977;39:Suppl:2948-58.
36. Smith IE, Fitzharris BM, McKinna JA, et al. Aminoglutethimide in treatment of metastatic breast carcinoma. Lancet 1978;2: 646-9.
37. Santen RJ, Santner S, Davis B, Veldhuis J, Samojlik E, Ruby E. Aminoglutethimide inhibits extraglandular estrogen production in postmenopausal women with breast carcinoma. J Clin Endocrinol Metab 1978;47: 1257-65.
38. Stuart-Harris R, Dowsett M, Bozek T, et al. Low-dose aminoglutethimide in treatment of advanced breast cancer. Lancet 1984;2:604-7.
39. Stein RC, Dowsett M, Headley A. Treatment of advanced breast cancer in postmenopausal women with 4-hydroxyandrostenedione. Cancer Chemother Pharmacol 1990;26:75-8.
40. Steele RE, Mellor LB, Sawyer WK, Wasvary JM, Browne LJ. In vitro and in vivo studies demonstrating potent and selective oestrogen inhibition with the nonsteroidal aromatase inhibitor CGS 16949A. Steroids 1987;50:147-61.
41. Buzdar AU, Smith R, Vogel C, et al. Fadrozole HCL (CGS-16949A) versus megestrol acetate treatment of postmenopausal patients with metastatic breast carcinoma: results of two randomized double blind controlled multiinstitutional trials. Cancer 1996; 77:2503-13.
42. Lonning PE, Jacobs S, Jones A, Haynes B, Powles T, Dowsett M. The influence of CGS 16949A on peripheral aromatisation in breast cancer patients. Br J Cancer 1991;63: 789-93.
43. Plourde PV, Dyroff M, Dowsett M, Demers L, Yates R, Webster A. ARIMIDEX: a new oral, once-a-day aromatase inhibitor. J Steroid Biochem Mol Biol 1995;53:175-9.
44. Bajetta E, Zilembo N, Bichisao E, et al. Tumor response and estrogen suppression in breast cancer patients treated with aromatase inhibitors. Ann Oncol 2000;11:1017-22.
45. Bisagni G, Cocconi G, Scaglione F, Fraschini F, Pfister C, Trunet PF. Letrozole, a new oral non-steroidal aromatase inhibitor in treating postmenopausal patients with advanced breast cancer: a pilot study. Ann Oncol 1996;7:99-102.
46. Lamb HM, Adkins JC. Letrozole: a review of its use in postmenopausal women with advanced breast cancer. Drugs 1998;56:1125-40.
47. Wiseman LP, Adkins JC. Anastrozole: a review of its use in the management of postmenopausal women with advanced breast cancer. Drugs Aging 1998;13:321-32.
48. Lonning PE. Pharmacological profiles of exemestane and formestane, steroidal aromatase inhibitors used for treatment of postmenopausal breast cancer. Breast Cancer Res Treat 1998;49:Suppl 1:S45-S52, S73-S77.
49. Lien FA, Anker G, Lonning PE, Solheim E, Ueland PM. Decreased serum concentrations of tamoxifen and its metabolites induced by aminoglutethimide. Cancer Res 1990;50:5851-7.
50. Pharmacokinetics of anastrozole and tamoxifen alone, and in combination, during adjuvant endocrine therapy for early breast cancer in postmenopausal women: a subprotocol of the 'Arimidex and tamoxifen alone or in combination' (ATAC) trial. Br J Cancer 2001;85:317-24.
51. Dowsett M, Pfister C, Johnston SR, et al. Impact of tamoxifen on the pharmacokinetics and endocrine effects of the aromatase inhibitor letrozole in postmenopausal women with breast cancer. Clin Cancer Res 1999; 5:2338-43.
52. Miller WR, Dixon JM. Antiaromatase agents: preclinical data and neoadjuvant therapy. Clin Breast Cancer 2000;1:Suppl 1: S9-S14.
53. Geisler J, King N, Anker G, et al. In vivo inhibition of aromatization by exemestane, a novel irreversible aromatase inhibitor, in postmenopausal breast cancer patients. Clin Cancer Res 1998;4:2089-93.
54. Geisler J, Haynes B, Anker G, Dowsett M, Lonning PE. Influence of letrozole and anastrozole on total body aromatization and plasma estrogen levels in postmenopausal breast cancer patients evaluated in a randomized, cross-over study. J Clin Oncol 2002;20: 751-7.
55. MacNeill FA, Jones AL, Jacobs S, Lonning PE, Powles TJ, Dowsett M. The influence of aminoglutethimide and its analogue rogletimide on peripheral aromatisation in breast cancer. Br J Cancer 1992;66:692-7.
56. Gershanovich M, Chaudri HA, Campos D, et al. Letrozole, a new oral aromatase inhibitor: randomised trial comparing 2.5 mg daily, 0.5 mg daily and aminoglutethimide in postmenopausal women with advanced breast cancer. Ann Oncol 1998;9:639-45.
57. Tominaga T, Morimoto T, Ohashi Y. A pivotal double-blind trial in Japan of an aromatase inhibitor letrozole (third-generation) vs. its predecessor fadrozole hydrochloride (second generation). Ann Oncol 2000;11:Suppl 4:25. abstract.
58. Bergh J, Bonneterre J, Illiger HJ, et al. Vorozole (Rivizor) versus aminoglutethimide (AG) in the treatment of advanced postmenopausal breast cancer relapsing after tamoxifen. Prog Proc Am Soc Clin Oncol 1997;16:155a. abstract.
59. Miller WR, Dixon JM. Local endocrine effects of aromatase inhibitors within the breast. J Steroid Biochem Mol Biol 2001;79: 93-102.
60. Mouridsen H, Gershanovich M, Sun Y, et al. Superior efficacy of letrozole versus tamoxifen as first-line therapy for postmenopausal women with advanced breast cancer: results of a phase III study of the International Letrozole Breast Cancer Group. J Clin Oncol 2001;19:2596-606. [Erratum, J Clin Oncol 2001;19:3302.]
61. Nabholtz JM, Buzdar A, Pollak M, et al. Anastrozole is superior to tamoxifen as first-line therapy for advanced breast carcinoma in postmenopausal women: results of a North American multicenter randomized trial. J Clin Oncol 2000;18:3758-67.
62. Bonneterre J, Thurlimann B, Robertson JER, et al. Anastrozole versus tamoxifen as first-line therapy for advanced breast cancer in 668 postmenopausal women: results of the Tamoxifen or Arimidex Randomized Group Efficacy and Tolerability study. J Clin Oncol 2000;18:3748-57.
63. Eiemann W, Paepke S, Appfelstaedt J, et al. Preoperative treatment of postmenopausal breast cancer patients with letrozole: a randomized double-blind multicenter study. Ann Oncol 2001;12:1527-32.
64. Ellis MJ, Coop A, Singh B, et al. Letrozole is more effective neoadjuvant endocrine therapy than tamoxifen for ErbB-1- and/or ErbB-2-positive, estrogen receptor-positive primary breast cancer: evidence from a phase III randomized trial. J Clin Oncol 2001; 19:3808-16.
65. Dirix L, Piccart MJ, Lohrisch C, et al. Efficacy of and tolerance to exemestane (E) versus tamoxifen (T) in 1st line hormone therapy (HT) of postmenopausal metastatic breast cancer (MBC) patients (pts): a European Organisation for the Research and Treatment of Cancer (EORTC Breast Group) phase II trial with Pharmacia Upjohn. Prog Proc Am Soc Clin Oncol 2001;20:29a. abstract.
66. Buzdar AU, Jonat W, Howell A, et al. Anastrozole versus megestrol acetate in the treatment of postmenopausal women with advanced breast carcinoma: results of a survival update based on a combined analysis of data from two mature phase III trials. Cancer 1998;83:1142-52. [Erratum, Cancer 1999;15:1010.]
67. Jonat W, Howell A, Blomqvist C, et al. A randomised trial comparing two doses of the new selective aromatase inhibitor anastrozole (Arimidex) with megestrol acetate in postmenopausal patients with advanced breast cancer. Eur J Cancer 1996;32A:404-12.
68. Buzdar A, Jonat W, Howell A, et al. Anastrozole, a potent and selective aromatase inhibitor, versus megestrol acetate in postmenopausal women with advanced breast cancer: results of overview analysis of two phase III trials. J Clin Oncol 1996; 14:2000-11.
69. Dombernowsky P, Smith I, Falkson G, et al. Letrozole, a new oral aromatase inhibitor for advanced breast cancer: double-blind randomized trial showing a dose effect and improved efficacy and tolerability compared with megestrol acetate. J Clin Oncol 1998;16:453-61.
70. Buzdar A, Douma N, Davidson N, et al. Phase III, multicenter, double-blind, randomized study of letrozole, an aromatase inhibitor, for advanced breast cancer versus megestrol acetate. J Clin Oncol 2001;19: 3357-66.
71. Kaufmann M, Bajetta E, Dirix LY, et al. Exemestane is superior to megestrol acetate after tamoxifen failure in postmenopausal women with advanced breast cancer: results of a phase III randomized double-blind trial. J Clin Oncol 2000;18:1399-411.
72. Goss PE, Winer EP, Tannock IF, Schwartz LH. Randomized phase III trial comparing the new potent and selective third-generation aromatase inhibitor vorozole with megestrol acetate in postmenopausal advanced breast cancer patients. J Clin Oncol 1999; 17:52-63.
73. Thurlimann B, Castiglione M, Hsu-Schmitz SF, et al. Formestane versus megestrol acetate in postmenopausal breast cancer patients after failure of tamoxifen: a phase III prospective randomised cross over trial of second-line hormonal treatment (SAKK 20/90). Eur J Cancer 1997;33:1017-24.
74. Hamilton A, Piccart M. The third-generation non-steroidal aromatase inhibitors: a review of their clinical benefits in the second-line hormonal treatment of advanced breast cancer. Ann Oncol 1999;10:377-84.
75. Cheung KL, Howell A, Robertson JF. Preoperative endocrine therapy for breast cancer. Endocr Relat Cancer 2000;7:131-41.
76. Smith IE, Lipton L. Preoperative/neoadjuvant medical therapy for early breast cancer. Lancet Oncol 2001;2:561-70.
77. Forrest AP, Levack PA, Chetty U, et al. A human tumour model. Lancet 1986;2: 840-2.
78. Dixon JM, Neoadjuvant endocrine therapy. In: Miller WR, Santen RJ, eds. Aromatase inhibition and breast cancer. New York: Marcel Dekker, 2000:103-16.
79. Miller WR, Dixon JM. Endocrine and clinical endpoints of exemestane as neoadjuvant therapy. Cancer Control 2002;9: Suppl:9-15.
80. Harper-Wynne CL, Sacks NPM, Shenton K, et al. Comparison of the systemic and intratumoral effects of tamoxifen and the aromatase inhibitor vorozole in postmenopausal patients with primary breast cancer. J Clin Oncol 2002;20:1026-35.
81. Benz CC, Scott GK, Sarup JC, et al. Estrogen-dependent, tamoxifen-resistant tumorigenic growth of MCF-7 cells transfected with HER2/neu. Breast Cancer Res Treat 1993;24:85-95.
82. Coombes RC, Powles TJ, Easton D, et al. Adjuvant aminoglutethimide therapy for postmenopausal patients with primary breast cancer. Cancer Res 1987;47:2494-7.
83. Jones AL, Powles TJ, Law M, et al. Adjuvant aminoglutethimide for postmenopausal patients with primary breast cancer: analysis at 8 years. J Clin Oncol 1992;10:1547-52.
84. Boccardo F, Rubagotti A, Amoroso D, et al. Sequential tamoxifen and aminoglutethimide versus tamoxifen alone in the adjuvant treatment of postmenopausal breast cancer patients: results of an Italian cooperative study. J Clin Oncol 2001;19:4209-15.
85. ATAC Trialists' Group. Anastrozole alone or in combination with tamoxifen versus tamoxifen alone for adjuvant treatment of postmenopausal women with early breast cancer: first results of the ATAC randomised trial. Lancet 2002;359:2131-9. [Erratum, Lancet 2002;360:1520.]
86. Winer EP, Hudis C, Burstein HJ, et al. American Society of Clinical Oncology technology assessment on the use of aromatase inhibitors as adjuvant therapy for women with hormone receptor-positive breast cancer: status report 2002. J Clin Oncol 2002; 20:3317-27.
87. Harper-Wynne C, Ross G, Sacks N, et al. Effects of the aromatase inhibitor letrozole on normal breast epithelial cell proliferation and metabolic indices in postmenopausal women: a pilot study for breast cancer prevention. Cancer Epidemiol Biomarkers Prev 2002;11:614-21.
88. Heshmati HM, Khosla S, Robins SP, O'Fallon WM, Melton LJ III, Riggs BL. Role of low levels of endogenous estrogen in regulation of bone resorption in late postmenopausal women. J Bone Miner Res 2002;17: 172-8.
89. Cummings SR, Black DM, Thompson DE, et al. Effect of alendronate on risk of fracture in women with low bone density but without vertebral fractures: results from the Fracture Intervention Trial. JAMA 1998; 280:2077-82.
90. Bruning PF, Bonfrer JMG, Hart AAM, et al. Tamoxifen, serum lipoproteins and cardiovascular risk. Br J Cancer 1988;58:497-9.
91. Saarto T, Blomqvist C, Ehnholm C, Taskinen MR, Elomaa I. Antiatherogenic effects of adjuvant antiestrogens: a randomized trial comparing the effects of tamoxifen and toremifene on plasma lipid levels in postmenopausal women with node-positive breast cancer. J Clin Oncol 1996;14:429-33.
92. McDonald CC, Alexander FE, Whyte BW, Forrest AP, Stewart HJ. Cardiac and vascular morbidity in women receiving adjuvant tamoxifen for breast cancer in a randomised trial. BMJ 1995;311:977-80.
93. Costantino JP, Kuller LH, Ives DG, Fisher B, Dignam J. Coronary heart disease mortality and adjuvant tamoxifen therapy. J Natl Cancer Inst 1997;89:776-82.
94. Rutqvist LE, Mattsson A. Cardiac and thromboembolic morbidity among postmenopausal women with early-stage breast cancer in a randomized trial of adjuvant tamoxifen. J Natl Cancer Inst 1993;85:1398-406.
95. Elisaf MS, Bairaktari ET, Nicolaides C, et al. Effect of letrozole on the lipid profile in postmenopausal women with breast cancer. Eur J Cancer 2001;37:1510-3.
96. Tang MX, Jacobs D, Stern Y, et al. Effect of oestrogen during menopause on risk and age at onset of Alzheimer's disease. Lancet 1996;348:429-32.
97. Shaywitz SE, Shaywitz BA, Pugh KR, et al. Effect of estrogen on brain activation patterns in postmenopausal women during working memory tasks. JAMA 1999;281: 1197-202.
98. O'Meara ES, Rossing MA, Daling JR, Elmore JG, Barlow WE, Weiss NS. Hormone replacement therapy after a diagnosis of breast cancer in relation to recurrence and mortality. J Natl Cancer Inst 2001;93:754-62.
99. Vassilopoulou-Sellin R, Asmar L, Hortobagyi GN, et al. Estrogen replacement therapy after localized breast cancer: clinical outcome of 319 women followed prospectively. J Clin Oncol 1999;17:1482-7.
100. Henderson BE, Bernstein L. The international variation in breast cancer rates: an epidemiological assessment. Breast Cancer Res Treat 1991;18:Suppl 1:S11-S17.
101. The Endogenous Hormones and Breast Cancer Collaborative Group. Endogenous sex hormones and breast cancer in postmenopausal women: reanalysis of nine prospective studies. J Natl Cancer Inst 2002; 94:606-16.
102. Rose C, Vtoraya O, Pluzanska A, et al. Letrozole (Femara) vs anastrozole (Arimidex): second-line treatment in postmenopausal women with advanced breast cancer. Prog Proc Am Soc Clin Oncol 2002;21:34a. abstract.
103. Lonning PE, Bajetta E, Murray R, et al. Activity of exemestane in metastatic breast cancer after failure of nonsteroidal aromatase inhibitors: a phase II trial. J Clin Oncol 2000;18:2234-44.
104. Carlini P, Frassoldati A, De Marco S, et al. Formestane, a steroidal aromatase inhibitor after failure of non-steroidal aromatase inhibitors (anastrozole and letrozole): is a clinical benefit still achievable? Ann Oncol 2001;12:1539-43.
105. Pritchard KI, Paterson AH, Fine S, et al. Randomized trial of cyclophosphamide, methotrexate, and fluorouracil chemotherapy added to tamoxifen as adjuvant therapy in postmenopausal women with node-positive estrogen and/or progesterone receptor-positive breast cancer: a report of the National Cancer Institute of Canada Clinical Trials Group. J Clin Oncol 1997;15: 2302-11.