Anastrozole And Fulvestrant For Post Menopausal, Estrogen Positive Breast Cancer.


Anastrozole and Fulvestrant are two drugs that are commonly used to treat estrogen (ER) positive breast cancers in postmenopausal patients. Anastrozole works by inhibiting estrogen synthesis while Fulvestrant binds and accelerates degradation of the estrogen receptors.

In this study, a combination of Anastrozole and low dose of Fulvestrant were used to treat postmenopausal women with previously untreated metastatic ER positive breast cancer.

For these woman, the combination of these two drugs was superior to Anastrozole alone with a median progression-free survival rate of 15.0 mths compared with 13.5 mth for Anastrozole alone. (Hazard ratio 0.80; 95% confidence interval [CI], 0.68 to 0.94; P=0.007 by the log-rank test).

Furthermore, the combination therapy provided an overall median survival rate of 47.7 mths compared with 41.3 mths for Anastrozole alone. (Hazard ratio 0.81; 95% CI, 0.65 to 1.00; P=0.05 by the log-rank test). See Fig 1.

I like this study because it shows how even a simple alteration of a standard treatment protocol can significantly improve the lives of a specific subgroup of breast cancer patients, without increasing the side effects.

FIGURE 1: Kaplan–Meier Curves for Progression-free Survival, According to Treatment Group. The overall hazard ratio for progression or death with the combination therapy is shown.

Mehta et al., (2012). Combination Anastrozole and Fulvestrant in Metastatic Breast Cancer. N Engl J Med; 367: 435-444.


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