Department of Surgery, Faculty of Medicine, Khon Kaen University, Thailand.
Breast Cancer (Dove Med Press). 2014 Aug 27;6:145-50. doi: 10.2147/BCTT.S67553. eCollection 2014.
Endocrine therapy is one of the standard treatments for estrogen-receptor-positive breast cancer patients. Letrozole is the only aromatase inhibitor (AI) included in Thailand's essential drug list since the change of reimbursement policy in 2008, when patients had to change their AIs (other than letrozole) to letrozole. This study aimed to prove that the efficacy of anastrozole plus letrozole is not less than anastrozole alone.
All medical records of breast cancer patients taking anastrozole between 2004 and 2013 were reviewed. Some patients were initially treated with anastrozole and then changed to letrozole (A-LTZ group), whereas the other patients were continuously treated with anastrozole until completion of therapy (ANZ group).
In a total of 180 (55.9%) out of the 322 cases, anastrozole was replaced with letrozole. The mean age of patients in the ANZ group was 54.9 years and that of those in the A-LTZ group was 54.2 years. Clinical stages (1-4) of the ANZ versus A-LTZ patients were four versus four, 76 versus 116, 46 versus 46, and 16 versus 14, respectively. ANZ patients took AI monotherapy (46.5%) and switching strategy (53.5%), while A-LTZ patients took AI monotherapy (53.9%) and switching strategy (46.1%). The overall survival (OS) of A-LTZ patients was longer than that of ANZ patients. Stage 2 and 4 patients in the A-LTZ group also had better OS than those in the ANZ group, but stage 3 patients had similar OS in both groups.
Anastrozole can be replaced by letrozole any time during endocrine therapy. The patients taking anastrozole plus letrozole surprisingly seemed to have better OS than patients taking anastrozole alone.
内分泌治疗是雌激素受体阳性乳腺癌患者的标准治疗方法之一。自 2008 年报销政策改变以来，来曲唑是泰国基本药物清单中唯一被纳入的芳香化酶抑制剂（AI），当时患者必须将他们的 AI（除来曲唑外）换成来曲唑。本研究旨在证明阿那曲唑加来曲唑的疗效不低于阿那曲唑单药治疗。
回顾了 2004 年至 2013 年间接受阿那曲唑治疗的乳腺癌患者的所有病历。一些患者最初接受阿那曲唑治疗，然后改用来曲唑（A-LTZ 组），而其他患者则连续接受阿那曲唑治疗，直至完成治疗（ANZ 组）。
在总共 322 例患者中，有 180 例（55.9%）将阿那曲唑换成了来曲唑。ANZ 组患者的平均年龄为 54.9 岁，A-LTZ 组为 54.2 岁。ANZ 组与 A-LTZ 组患者的临床分期（1-4 期）分别为 4 例和 4 例、76 例和 116 例、46 例和 46 例、16 例和 14 例。ANZ 组患者接受 AI 单药治疗（46.5%）和转换策略（53.5%），而 A-LTZ 组患者接受 AI 单药治疗（53.9%）和转换策略（46.1%）。A-LTZ 组患者的总生存期（OS）较长。A-LTZ 组的 2 期和 4 期患者的 OS 也优于 ANZ 组，但 3 期患者的 OS 在两组中相似。
阿那曲唑在接受内分泌治疗期间任何时候都可以被来曲唑取代。接受阿那曲唑加来曲唑治疗的患者的 OS 似乎明显好于接受阿那曲唑单药治疗的患者。
