Extended aromatase inhibitors delay breast cancer recurrence in meta-analysis

  • Xu L & et al.
  • Clin Breast Cancer
  • 19 Apr 2019

  • curated by Deepa Koli
  • Univadis Clinical Summaries
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Takeaway

  • In patients with early-stage breast cancer, extended adjuvant therapy with aromatase inhibitors (AIs) significantly improved disease-free survival (DFS), especially for contralateral breast cancer recurrence.
  • No significant differences were observed in overall survival (OS), distant metastatic recurrence, locoregional recurrence, and grade ≥3 adverse events.

Why this matters

  • The data on the effects of extended AI therapy in early-stage breast cancer are limited and inconclusive.

Study design

  • Meta-analysis of 7 randomized clinical trials including 16,926 patients with early-stage breast cancer identified after a search on PubMed, EmBase, and the Cochrane library until March 2018.
  • Patients were randomly assigned to either extended adjuvant therapy with AIs or control group (shorter AIs, placebo, or observation).
  • Funding: National Key R&D Program of China.

Key results

  • Extended AIs were not associated with significant improvement in OS (6 studies; HR, 0.95; P=.488)
  • DFS was significantly prolonged in patients on extended AIs vs control group (7 studies; HR, 0.75; P<.001>
  • Extended AIs significantly reduced the risk for contralateral breast cancer recurrence (relative risk [RR], 0.46; P<.001>
  • No significant difference was observed in distant metastatic recurrence (RR, 0.80; P=.055) and locoregional recurrence (RR, 0.76; P=.127) between groups.
  • No significant difference was observed in grade ≥3 adverse events.

Limitations

  • Moderate heterogeneity for DFS.

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