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