Up-front use of aromatase inhibitors as adjuvant therapy for breast cancer: the emperor has no clothes

Seruga, Bostjan; Tannock, Ian F.

doi:10.1200/jco.2008.19.5594

Cited by 53Breast Cancer Treatment StudiesEstrogen and related hormone effectsAdvanced Breast Cancer Therapies

Up-front use of aromatase inhibitors as adjuvant therapy for breast cancer: the emperor has no clothes

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Seruga, Bostjan, Tannock, Ian F.·2009·Journal of Clinical Oncology

DOI 10.1200/jco.2008.19.5594

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Abstract

nology assessment on adjuvant use of aromatase inhibitors (AIs) was updated to indicate that optimal adjuvant endocrine therapy for post-menopausal women with receptor-positive breast cancer should in-clude an AI, either as up-front therapy or as sequential therapy after tamoxifen.1 This recommendation was on the basis of improved disease-free survival (DFS) observed with AIs, given that no trial at that time had demonstrated improvement in overall survival. This recommendation and thepublicity relating to trials such as theArimi-dex, Tamoxifen, Alone or in Combination (ATAC) trial have had substantial impact worldwide on the endocrine treatment of early breast cancer.2 On the basis of the recent published update of the ATAC trial with a median 8 or more years of follow-up, and the report at the San Antonio Breast CancerMeeting inDecember 2007, advertisements proclaim that the long-term data demonstrate con-tinuing effectiveness for anastrozole over tamoxifen through treat-

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The validity of using DFS, RFS, EFS, distant disease-free survival and TTR as surrogates for survival in curative settings is relatively well supported by data from solid tumour settings including colon, gastric, lung and breast cancers.
“The validity of this approach, though not uncontroversial [13], is relatively well supported by data derived from a wide range of solid tumour settings including in colon [14], gastric [15], lung [16] and breast [17] cancers.”
From A standardised, generic, validated approach to stratify the magnitude of clinical benefit that can be anticipated from anti-cancer therapies: the European Society for Medical Oncology Magnitude of Clinical Benefit Scale (ESMO-MCBS) (2015) · cites this paper as [13]

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Authors: Seruga, B., & Tannock, I. F.
Affiliations: Division of Medical Oncology and Hematology, Princess Margaret Hospital, Toronto, Ontario, Canada
Princess Margaret Cancer Centre (CA)
ORCID: Tannock, Ian F.
Venue: Journal of Clinical Oncology
Publisher: American Society of Clinical Oncology (ASCO)
Published: 2009-02-20
Volume: 27
Issue: 6
Pages: 840-842
ISSN: 0732-183X (ISSN-L)
1527-7755
DOI: 10.1200/jco.2008.19.5594
OpenAlex: W2155357724
Cited by: 53
References: 33
Citations by year: 2025: 2 · 2023: 1 · 2021: 2 · 2020: 3 · 2018: 1 · 2017: 6 · 2016: 1 · 2015: 1 · 2014: 2 · 2013: 4
FWCI: 3.36
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: Journal of Clinical Oncology (publishedVersion)
PubMed (publishedVersion)
Topics: Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Breast Cancer Treatment Studies
Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Estrogen and related hormone effects
Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Advanced Breast Cancer Therapies
Keywords: aromatase inhibitors, adjuvant endocrine therapy, early breast cancer, anastrozole, tamoxifen, ATAC trial, disease-free survival, overall survival, postmenopausal women, sequential endocrine therapy
MeSH terms: Breast Neoplasms, Female, Humans, Survival Analysis, Disease-Free Survival, Neoadjuvant Therapy, Aromatase Inhibitors

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Up-front use of aromatase inhibitors as adjuvant therapy for breast cancer: the emperor has no clothes

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