Anastrozole+fulvestrant tops anastrozole alone in HR+ advanced breast cancer: meta-analysis

  • Li M & al.
  • Breast Cancer Res Treat
  • 1 Feb 2020

  • curated by Miriam Davis, PhD
  • Univadis Clinical Summaries
Access to the full content of this site is available only to registered healthcare professionals. Access to the full content of this site is available only to registered healthcare professionals.

Takeaway

  • The combination of anastrozole plus fulvestrant delivers superior OS and PFS compared with anastrozole alone for hormone receptor-positive (HR+) advanced breast cancer (aBCa).
  • But the combination carries more adverse events (AEs), according to the results of this meta-analysis.

Why this matters

  • The combination may work as intended, overcoming resistance to endocrine therapy.
  • Findings suggest that the combination is the preferred treatment option, but patients must be informed about AEs.

Study design

  • A meta-analysis of 4 randomized controlled trials (RCTs) involving 2146 patients.
  • Funding: National Natural Science Foundation of China; others.

Key results

  • The combination group (vs anastrozole alone) had better:
    • OS: HR, 0.86 (P=.03).
    • PFS: HR, 0.87 (P=.02).
  • No difference between groups in objective response rates, disease control rate, total AEs, and grade 3-5 AEs.
  • The combination group had a higher rate (risk ratios) of the following most common AEs:
    • Influenza-like symptoms: 1.26 (P=.002).
    • Gastrointestinal disorders: 1.20 (P=.02).
    • Extremity/muscle pain: 1.18 (P=.07).
    • Hot flashes: 1.55 (P=.007).
    • Hematologic effects: 1.69 (P=.004).
    • Fatigue: 2.75 (P=.003).
    • Bone pain: 2.10 (P=.03).

Limitations

  • Small number of RCTs.