The use of third-generation aromatase inhibitors (AIs) in the treatment of advanced breast cancer in postmenopausal women shows survival benefits.
A Cochrane review compared AIs to other endocrine therapy in the treatment of advanced breast cancer in postmenopausal women, with 25 studies included in the main analysis (n=9,416).
The main findings were as follows. AIs were associated with a significant survival benefit over other endocrine therapies, and were not associated with any statistically significant difference in progression-free survival, clinical benefit and objective response. There were very limited data to compare one AI with a different AI, but these suggested an advantage for letrozole over anastrozole.
In the studies of AIs as first-line therapy (all versus tamoxifen), AIs were associated with statistically significant improvements in progression-free survival and clinical benefit, but not survival or objective response.
Finally, the use of an AI as second-line therapy showed a significant benefit in terms of overall survival but not for progression-free survival, clinical benefit or objective response.