Abstract
Postmenopausal breast cancer is frequently hormone responsive and may be treated with agents that prevent estrogen activity. Tamoxifen is the most widely used of these agents, proving effective in both early and advanced disease. However, the role of tamoxifen has been challenged by the development of newer agents which have demonstrated at least equivalent activity and better tolerability, notably the nonsteroidal third-generation aromatase inhibitor anastrozole, which is currently the only other agent approved for primary adjuvant treatment of early disease and first-line treatment of advanced disease.
In postmenopausal women with early breast cancer, anastrozole was associated with a significantly higher rate of disease-free survival (86.9% vs 84.5%) and a lower incidence of contralateral breast cancer than tamoxifen. Furthermore, the incidences of thromboembolic events and endometrial cancer were significantly lower with anastrozole. However, anastrozole was associated with an increase in musculoskeletal events (including fractures) and further evaluation of the clinical significance of this finding is warranted. Pharmacoeconomic analyses based on the results of this trial and conducted from different healthcare perspectives have all found anastrozole to be a cost-effective adjuvant therapy for early postmenopausal breast cancer. Clinical trial data indicate that switching patients who have already received 2 years’ tamoxifen treatment to anastrozole reduces the risk of relapse and death compared with continuing treatment with tamoxifen. Further studies are warranted to determine the optimum sequence of agents and duration of adjuvant therapy.
Large well designed trials have also shown first-line anastrozole therapy is at least as effective as tamoxifen in prolonging time to disease progression and overall survival in patients with advanced disease. Current data indicate that the drug is more effective than tamoxifen in patients whose tumors are known to express the estrogen receptor. Pharmacoeconomic analyses conducted from various healthcare perspectives support the use of anastrozole as a cost-effective treatment in this indication.
Anastrozole has demonstrated similar efficacy to that of other approved agents, including letrozole and fulvestrant, as second-line therapy for patients who have failed first-line therapy (in most cases with tamoxifen).
In conclusion, clinical and pharmacoeconomic data support the role of anastrozole as a primary adjuvant treatment for use across the entire spectrum of breast cancer encompassing early disease through to advanced metastatic disease, and reflect current treatment guidelines. Anastrozole has also proven effective in clinical trials in the neoadjuvant setting, though its use in this setting and in breast cancer prevention remains to be fully elucidated.
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References
Goodwin PJ. Economics, quality of life and breast cancer outcomes: is a balance possible? Breast 2001; 10 Suppl. 3: 190–8
American Cancer Society. Cancer facts and figures 2005 [online]. Available from URL: http://www.cancer.org [Accessed 2005 Jul 25]
National Institute for Clinical Excellence. Guidance on cancer services: improving outcomes in breast cancer [online]. Available from URL: http://www.nice-org.uk [Accessed 2004 Sep 22]
Diab SG, Elledge RM, Clark GM. Tumor characteristics and clinical outcome of elderly women with breast cancer. J Natl Cancer Inst 2000; 92(7): 550–6
Miller WR, Mullen P, Sourdaine P, et al. Regulation of aromatase activity within the breast. J Steroid Biochem Mol Biol 1997; 61: 193–202
Mouridsen HT, Rose C, Brodie AH, et al. Challenges in the endocrine management of breast cancer. Breast 2003; 12 Suppl. 2: S2–19
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
Clemons M, Goss P. Estrogen and the risk of breast cancer. N Engl J Med 2001; 344(4): 276–85
AstraZeneca Pharmaceuticals Ltd. AstraZeneca’s breast cancer treatment Arimidex® granted new indication enabling wider access for postmenopausal women [online]. Available from URL: http://www.astrazeneca.com [Accessed 2005 Jul 4]
Buzdar AU. Role of anastrozole in adjuvant therapy for postmenopausal patients. Semin Oncol 2003; 30 (5 Suppl. 16): 21–9
van Landeghem AAJ, Poortman J, Nabuurs M, et al. Endogenous concentration and subcellular distribution of estrogens in normal and malignant human breast tissue. Cancer Res 1985; 45: 2900–6
Blankenstein MA, Szymczak J, Daroszewski J, et al. Estrogens in plasma and fatty tissue from breast cancer patients and women undergoing surgery for non-oncological reasons. Gynecol Endocrinol 1992; 6: 13–7
European Society of Medical Oncologists Guidelines Task Force. ESMO minimum clinical recommendations for the diagnosis, adjuvant treatment and follow-up of primary breast cancer. Ann Oncol 2005; 16 Suppl. 1: i7–9
American Cancer Society. Statistics [online]. Available from URL: http://www.cancer.org [Accessed 2001 Apr 20]
Kmietowicz Z. British cancer death rates fell by 12% between 1972 and 2002. Br Med J 2004; 328: 303
Cuzick J. Epidemiology of breast cancer: selected highlights. Breast 2003; 12(6): 405–11
McPherson K, Steel CM, Dixon JM. Breast cancer — epidemiology, risk factors, and genetics. Br Med J 2000; 321: 624–8
Radice D, Redaelli A. Breast cancer management: quality-of-life and cost considerations. Pharmacoeconomics 2003; 21(6): 383–96
Berkowitz N, Gupta S, Silberman G. Estimates of lifetime direct costs of treatment for metastatic breast cancer. Value Health 2000; 3(1): 23–30
Richards MA, Braysher S, Gregory WM, et al. Advanced breast cancer: use of resources and cost implications. Br J Cancer 1993; 67: 856–60
Wolstenholme JL, Smith SJ, Whynes DK. The cost of treating breast cancer in the United Kingdom: implications for screening. Int J Technol Assess Health Care 1998; 14(2): 277–89
Will BP, Berthelot J-M, Le Petit C, et al. Estimates of the lifetime costs of breast cancer treatment in Canada. Eur J Cancer 2000; 36: 724–35
Simon MS, Ibrahim D, Newman L, et al. Efficacy and economics of hormonal therapies for advanced breast cancer. Drugs Aging 2002; 19(6): 453–63
Taplin SH, Barlow W, Urban N. Stage, age, comorbidity and direct costs of colon, prostate and breast cancer. J Natl Cancer Inst 1995; 85(6): 417–26
Rao S, Kubisiak J, Gilden D. Cost of illness associated with metastatic breast cancer. Breast Cancer Res Treat 2004; 83(1): 25–32
Cocquyt V, Moeremans K, Annemans L, et al. Long-term medical costs of postmenopausal breast cancer therapy. Ann Oncol 2003; 14(7): 1057–63
Blarney RW, Wilson ARM, Patnick J. ABC of breast diseases: screening for breast cancer. Br Med J 2000; 321: 689–93
American Cancer Society. Detailed guide: breast cancer. Can breast cancer be found early? [online]. Available from URL: http://www.cancer.org [Accessed 2004 Sep 27]
National Comprehensive Cancer Network. Clinical practice guidelines in oncology: breast cancer version 2.2005 [online]. Available from URL: http://www.nccn.org [Accessed 2005 Jun 17]
European Society of Medical Oncologists Guidelines Task Force. ESMO minimum clinical recommendations for diagnosis, treatment and follow-up of locally recurrent or metastatic breast cancer (MBC). Ann Oncol 2005; 16 Suppl. 1: i10–2
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 postmenopausal women with hormone receptor-positive breast cancer: status report 2004. J Clin Oncol 2005; 23(3): 619–29
ATAC (Arimidex, Tamoxifen Alone or in Combination) Trialists’ Group. Anastrozole alone or in combination with tamoxifen versus tamoxifen alone for adjuvant treatment of postmenopausal women with early-stage breast cancer: results of the ATAC (Arimidex, Tamoxifen Alone or in Combination) trial efficacy and safety update analyses. Cancer 2003; 98(9): 1802–10
ATAC (Arimidex, Tamoxifen Alone or in Combination) 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(9324): 2131–9
Buzdar AU, ATAC Trialists’ Group. Impact of adjuvant chemotherapy prior to endocrine therapy: 68 month results from the ‘Arimidex’, Tamoxifen, Alone or in Combination (ATAC) trial [abstract no. 608]. J Clin Oncol 2005; 23 (16 Suppl. Pt 1): 30s
ATAC Trialists’ Group. Results of the ATAC (Arimidex, Tamoxifen, Alone or in Combination) trial after completion of 5 years’ adjuvant treatment for breast cancer. Lancet 2005; 365(9453): 60–2
AstraZeneca Pharmaceuticals Limited USA. Arimidex®: anastrozole tablets prescribing information [online]. Available from URL: http://www.astrazeneca.com [Accessed 2004 Sep 22]
Pharmacia Limited. Aromasin: summary of product characteristics [online]. Available from URL: http://www.emc.medicines.org.uk [Accessed 2004 Sep 22]
AstraZeneca UK Limited. Faslodex [online]. Available from URL: http://ultra.eudra.org [Accessed 2004 Sep 22]
Novartis Pharmaceuticals UK Ltd. Femara: summary of product characteristics [online]. Available from URL: http://emc.medicines.org.uk [Accessed 2004 Sep 22]
Bristol-Myers Pharmaceuticals. Meagace tablets: summary of product characteristics [online]. Available from URL: http://emc.medicines.org.uk [Accessed 2004 Sep 22]
CP Pharmaceuticals Limited. Tamoxifen tablets BP 10mg: summary of product characteristics [online]. Available from URL: http://emc.medicines.org.uk [Accessed 2004 Sep 22]
Nabholtz JM, Buzdar A, Pollak M, et al. Anastrozole is superior to tamoxifen as first-line therapy for advanced breast cancer in postmenopausal women: results of a North American multicenter randomized trial. J Clin Oncol 2000; 18(22): 3758–67
Nabholtz JM, Bonneterre J, Buzdar A, et al. Anastrozole (Arimidex™) versus tamoxifen as first-line therapy for advanced breast cancer in postmenopausal women: survival analysis and updated safety results. Eur J Cancer 2003; 39(12): 1684–9
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(10): 2596–606
Bonneterre J, Thürlimann B, Robertson JFR, 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
Carlson RW, Henderson IC. Sequential hormonal therapy for metastatic breast cancer after adjuvant tamoxifen or anastrozole. Breast Cancer Res Treat 2003; 80 Suppl. 1: S19–26; discussion S27-8
Plourde PV, Dyroff M, Dukes M. Arimidex®: a potent and selective fourth-generation aromatase inhibitor. Breast Cancer Res Treat 1994; 30(1): 103–11
Geisler J, King N, Dowsett M, et al. Influence of anastrozole (Arimidex), a selective, non-steroidal aromatase inhibitor, on in vivo aromatisation and plasma oestrogen levels in postmenopausal women with breast cancer. Br J Cancer 1996; 74: 1286–91
Miller WR, Stuart M, Sahmoud T, et al. Anastrozole (’Arimidex’) blocks oestrogen synthesis both peripherally and within the breast in postmenopausal women with large operable breast cancer. Br J Cancer 2002; 87(9): 950–5
Geisler J, Detre S, Bernsten H, et al. Influence of neoadjuvant anastrozole (Arimidex) on intratumoral estrogen levels and proliferation markers in patients with locally advanced breast cancer. Clin Cancer Res 2001; 7: 1230–6
Buzdar AU. Pharmacology and pharmacokinetics of the newer generation aromatase inhibitors. Clin Cancer Res 2003; 9 Suppl.: 468S–72S
Boccardo F, Rubagotti A, Puntoni M, et al. Switching to anastrozole versus continued tamoxifen treatment of early breast cancer: preliminary results of the Italian Tamoxifen Anastrozole trial. J Clin Oncol 2005; 23(22): 5138–47
Jakesz R, Jonat W, Gnant M, et al. Switching of postmenopausal women with endocrine-responsive early breast cancer to anastrozole after 2 years’ adjuvant tamoxifen: combined results of ABCSG trial 8 and ARNO 95 trial. Lancet 2005; 366(9484): 455–62
Boccardo FM, Rubagotti A, Puntoni A, et al. Switching to anastrozole (ANA) vs continued tamoxifen (TAM) treatment of early breast cancer (EBC). Updated results of the Italian Tamoxifen Anastrozole (ITA) trial [abstract no. 526]. J Clin Oncol 2005; 23 (16 Suppl. Pt 1): 10
Jakesz R, Samonigg H, Greil M, et al. Extended adjuvant treatment with anastrozole: results from the Austrian Breast and Colorectal Cancer Study Trial 6a (ABCSG-6a) [abstract no. 527]. J Clin Oncol 2005; 23 (16 Suppl. Pt 1): 10s. Plus poster presented at the 41st Annual Meeting of the American Society of Clinical Oncology; 2005 May 13–17; Orlando (FL)
Cataliotti L, Buzdar A, Noguchi S, et al. Efficacy of PRe-Operative Arimidex (anastrozole) Compared with Tamoxifen (PROACT) as neoadjuvant therapy in postmenopausal women with hormone receptor-positive breast cancer [abstract no. 46]. Eur J Cancer Suppl 2004; 2(3): 69
Semiglazov V, Semiglazov VV, Ivanov VG, et al. Anastrozole (A) vs tamoxifen (T) vs combine (A + T) as neoadjuvant endocrine therapy of postmenopausal breast cancer patients [abstract no. 3538]. Proceedings of the 39th Annual meeting of the American Society of Clinical Oncology; 2003 May 31–Jun 3. Chicago (IL): ASCO 2003; 22: 880
Dixon JM, Renshaw L, Bellamy C, et al. The effects of neoadjuvant anastrozole (Arimidex) on tumor volume in postmenopausal women with breast cancer: a randomized, double-blind, single-center study. Clin Cancer Res 2000; 6: 2229–35
Milla-Santos A, Milla L, Calvo N, et al. Anastrozole as neoadjuvant therapy for patients with hormone-dependent, locally-advanced breast cancer. Anticancer Res 2004; 24(2C): 1315–8
Smith IE, Dowsett M, Ebbs SR, et al. Neoadjuvant treatment of postmenopausal breast cancer with anastrozole, tamoxifen, or both in combination: the IMmediate Preoperative Anastrozole, tamoxifen, or Combined with Tamoxifen (IMPACT) multicenter double-blind randomized trial. J Clin Oncol 2005; 23(22): 5108–16
Smith I, Cataliotti L, IMPACT and PROACT Trialists. Anastrozole versus tamoxifen as neoadjuvant therapy for oestrogen receptor-positive breast cancer in postmenopausal women: the IMPACT and PROACT trials [abstract no. 47]. Eur J Cancer Suppl 2004; 2(3): 69–70
Banerjee S, Smith IE, Folkerd L, et al. Comparative effects of anastrozole, tamoxifen alone and in combination on plasma lipids and bone-derived resorption during neoadjuvant therapy in the IMPACT trial. Ann Oncol 2005 Jul 15 [Epub ahead of print]
Milla-Santos A, Milla L, Portella J, et al. Anastrozole versus tamoxifen as first-line therapy in postmenopausal patients with hormone-dependent advanced breast cancer: a prospective, randomized, phase III study. Am J Clin Oncol 2003; 26: 317–22
Bonneterre J, Buzdar A, Nabholtz JM, et al. Anastrozole is superior to tamoxifen as first-line therapy in hormone receptor positive advanced breast carcinoma: results of two randomized trials designed for combined analysis. Cancer 2001; 92(9): 2247–58
Buzdar AU, Jones SE, Vogel CL, et al. A phase III trial comparing anastrozole (1 and 10 milligrams), a potent and selective aromatase inhibitor, with megestrol acetate in postmenopausal women with advanced breast carcinoma. Cancer 1997; 79(4): 730–9
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(3): 404–12
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. Arimidex Study Group [published erratum appears in Cancer 1999; 85 (4): 1010]. Cancer 1998; 83(6): 1142–52
Howell A, Buzdar A, Jonat W. Arimidex™ (anastrozole): effective in advanced breast cancer (ABC) patients with visceral and liver metastases [abstract]. Breast Cancer Res Treat 1998; 50(3): 304
Osborne CK, Pippen J, Jones SE, et al. Double-blind, randomized trial comparing the efficacy and tolerability of fulvestrant versus anastrozole in postmenopausal women with advanced breast cancer progressing on prior endocrine therapy: results of a North American trial. J Clin Oncol 2002; 20(16): 3386–95
Howell A, Robertson JFR, Quaresma Albano J, et al. Fulvestrant, formerly ICI 182,780, is as effective as anastrozole in postmenopausal women with advanced breast cancer progressing after prior endocrine treatment. J Clin Oncol 2002; 20(16): 3396–403
Howell A, Robertson JFR, Vergote I, et al. Fulvestrant versus anastrozole for the treatment of advanced breast cancer: survival analysis from a phase III trial [abstract no. 178]. Proceedings of the 39th Annual Meeting of the American Society of Clinical Oncology; 2003 May 31–Jun 3. Chicago (IL): ASCO 2003; 22: 45
Robertson JF, Osborne CK, Howell A, et al. Fulvestrant versus anastrozole for the treatment of advanced breast carcinoma in postmenopausal women: a prospective combined analysis of two multicenter trials. Cancer 2003; 98(2): 229–38
Rose C, Vtoraya O, Pluzanska A, et al. An open randomised trial of second-line endocrine therapy in advanced breast cancer: comparison of the aromatase inhibitors letrozole and anastrozole. Eur J Cancer 2003; 39(16): 2318–27
Thürlimann B, Robertson JFR, Nabholtz JM, et al. Efficacy of tamoxifen following anastrozole (Arimidex) compared with anastrozole following tamoxifen as first-line treatment for advanced breast cancer in postmenopausal women. Eur J Cancer 2003; 39(16): 2310–7
Thürlimann B, Hess D, Koberle D, et al. Anastrozole (’Arimidex’) versus tamoxifen as first-line therapy in postmenopausal women with advanced breast cancer: results of the double-blind cross-over SAKK trial 21/95 — a sub-study of the TARGET (Tamoxifen or ‘Arimidex’ Randomized Group Efficacy and Tolerability) trial. Breast Cancer Res Treat 2004; 85(3): 247–54
Eastell R, Adams J. Results of the Arimidex (anastrozole, A), Tamoxifen (T), Alone or in Combination (ATAC) trial: effects on bone mineral density (BMD) and bone turnover (ATAC Trialists’ Group) [abstract no. 113PD]. Ann Oncol 2002; 13 Suppl. 5: 32
Fallowfield L, Cella D, Cuzick J, et al. Quality of life of postmenopausal women in the Arimidex, Tamoxifen, Alone or in Combination (ATAC) Adjuvant Breast Cancer Trial. J Clin Oncol 2004; 22(21): 4261–71
Cella D, Fallowfield L, on behalf of the ATAC Trialists’ Group. Five-year quality of life (QOL) follow-up of adjuvant endocrine therapy for postmenopausal women in the Arimidex (A), Tamoxifen (T), Alone or in Combination (ATAC) trial [abstract no. 577]. J Clin Oncol 2005; 23 (16 Suppl. Pt 1): 23s
Mansel RE. Cost-utility analysis of anastrozole vs tamoxifen in postmenopausal women with early breast cancer from a UK national health service perspective: the 5-year completed treatment analysis of ATAC (’Arimidex’, Tamoxifen Alone or in Combination) trial [abstract no. 653]. Plus poster presented at the 41st Annual Meeting of the American Society of Clinical Oncology; 2005 May 13–17, Orlando (FL). J Clin Oncol 2005; 23 (16 Suppl. Pt 1): 41.
Benedict A, Christie Á. Budget impact analysis of anastrozole as adjuvant therapy in the treatment of early breast cancer in the UK [abstract no. PCN12]. Value Health 2003; 6(6): 735
Annemans L, Moeremans K, Lamarque H. Health economic assessment of the ATAC trial comparing anastrozole versus tamoxifen in adjuvant treatment of postmenopausal hormone receptor positive early breast cancer [abstract no. CE2]. Value Health 2003; 6(6): 625
Verma S, Rocchi A, Cheung S. Canadian cost-effectiveness analysis of anastrozole versus tamoxifen in early breast cancer [abstract no. 648 plus poster]. 26th Annual San Antonio Breast Cancer Symposium; 2003 Dec 3–6; San Antonio (TX)
Locker GY. Cost-utility analysis of anastrozole versus tamoxifen as adjuvant therapy in postmenopausal women with early breast cancer from a US healthcare perspective. The ATAC Trialists’ Group [abstract no. 2085]. Breast Cancer Res Treat 2004; 88 Suppl. 1: 105. Plus poster presented at the 27th Annual San Antonio Breast Cancer Symposium; 2004 Dec 8–11, San Antonio (TX)
Hillner BE. Benefit and projected cost-effectiveness of anastrozole versus tamoxifen as initial adjuvant therapy for patients with early-stage estrogen receptor-positive breast cancer. Cancer 2004; 101(6): 1311–22
Marchetti M, Liberato N, Barosi G. First-line therapy for advanced breast cancer: cost-effectiveness of anastrozole versus tamoxifen [abstract no. PCN5]. Value Health 2001; 4(6): 433
Simons WR, Jones D, Buzdar A. Cost-effectiveness of anastrozole versus tamoxifen as first-line therapy for postmenopausal women with advanced breast cancer. Clin Ther 2003; 25(11): 2972–87
Simons R, Bassi R, Jones D, et al. Cost analysis of treatment-related adverse events with anastrozole (Arimidex) versus tamoxifen in postmenopausal women with hormone receptor-positive (HR+) advanced breast cancer (ABC): a UK perspective [abstract no. 339]. Eur J Cancer 2002; 38 Suppl. 3: S131
Dranitsaris G, Verma S, Trudeau M. Cost utility analysis of first-line hormonal therapy in advanced breast cancer: comparison of two aromatase inhibitors to tamoxifen. Am J Clin Oncol 2003; 26: 289–96
Liberato L, Marchetti M, Barosi G. Cost-effectiveness of anastrozole as first line therapy for advanced breast cancer in postmenopausal women [abstract no. B1]. Ann Oncol 2001; 12 Suppl. 4: 18
Simons R, Bassi R, Jones D, et al. Cost-effectiveness analysis of anastrozole (Arimidex) versus tamoxifen as first-line therapy in postmenopausal women with hormone receptor-positive advanced breast cancer (ABC): a UK perspective [abstract no. 116]. Eur J Cancer 2002; 38 Suppl. 3: S68
Marchetti M, Caruggi M, Colombo G. Cost utility and budget impact of third-generation aromatase inhibitors for advanced breast cancer: a literature-based model analysis of costs in the Italian National Health Service. Clin Ther 2004; 26(9): 1546–61
Drummond M, Thompson E, Howell A, et al. Cost-effectiveness implications of increased survival with anastrozole in the treatment of advanced breast cancer. J Drug Assess 1999; 2: 169–79
Verma S, Rocchi A. Economic evaluation of antiaromatase agents in the second-line treatment of metastatic breast cancer. Support Care Cancer 2003; 11: 728–34
Dranitsaris G, Leung P, Mather J, et al. Cost-utility analysis of second-line hormonal therapy in advanced breast cancer: a comparison of two aromatase inhibitors to megestrol acetate. Anti-Cancer Drugs 2000; 11: 591–601
Cuzick J. Aromatase inhibitors in prevention: data from the ATAC (Arimidex, Tamoxifen Alone or in Combination) trial and the design of IBIS-II (the second International Breast Cancer Intervention Study). Recent Results Cancer Res 2003; 163: 96–103; discussion 264-6
IBIS Investigators. First results from the International Breast Cancer Intervention Study (IBIS-1): a randomized prevention trial. Lancet 2002; 360(9336): 817–24
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Various sections of the manuscript reviewed by: M. Baum, Department of Surgery, University College of London, London, England; A.U. Buzdar, Department of Breast Medical Oncology, MD Anderson Cancer Center, University of Texas, Houston, Texas, USA; J. Cuzick, Department of Mathematics, Statistics and Epidemiology, Imperial Cancer Research Fund, London, England; G. Dranitsaris, Augmentium Pharma Consulting, Toronto, Ontario, Canada; A. Howell, CRUK Department of Medical Oncology, Christie Hospital NHS Trust, Manchester, England; A. Milla-Santos, Medical Oncology Service Sanitas Hospitales, Barcelona, Spain; A. Rocchi, Axia Research, Hamilton, Ontario, Canada.
Data Selection
Sources: Medical literature published in any language since 1980 on anastrozole, identified using MEDLINE, supplemented by AdisBase (a proprietary database of Adis International). Additional references were identified from the reference lists of published articles. Bibliographical information, including contributory unpublished data, was also requested from the company developing the drug.
Search strategy: MEDLINE search terms were ‘breast cancer’ and (‘guidelines’ or ‘decision-making’ or ‘health-policy’ or ‘managed-care-programmes’ or ‘epidemiology’ or ‘outcome-assessment-health-care’ or ‘clinical-protocols’ or ‘guideline in pt’ or ‘polic* in ti’ or ‘expert panel’ or ‘utilization review’ or ‘algorithms’ or ‘disease management’ or ‘quality of life’), or ‘anastrozole’ and ‘review in pt’. AdisBase search terms were ‘breast cancer’ and (‘guideline’ or ‘guideline-utilisation’ or ‘practice-guideline’ or ‘disease-management-programmes’ or ‘treatment-algorithms’ or ‘reviews-on-treatment’ or ‘drug-evaluations’ or ‘epidemiology’ or ‘cost-of-illness’ or ‘pathogenesis’), or ‘anastrozole’ and (‘review’ or ‘clinical-study’). Searches were last updated 5 September 2005.
Selection: Studies in patients with hormone-responsive breast cancer who received anastrozole. Inclusion of studies was based mainly on the methods section of the trials. When available, large, well controlled trials with appropriate statistical methodology were preferred. Relevant pharmacodynamic, pharmacokinetic, pharmacoeconomic and epidemiological data are also included.
Index terms: Anastrozole, aromatase inhibitor, breast cancer, disease management, review on treatment.
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Wiseman, L.R., Scott, L.J. Management of Hormone-Responsive Postmenopausal Breast Cancer. Dis-Manage-Health-Outcomes 13, 337–354 (2005). https://doi.org/10.2165/00115677-200513050-00006
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DOI: https://doi.org/10.2165/00115677-200513050-00006