Macharia Henry Gachoki, Degu Amsalu
Department of Pharmaceutics and Pharmacy Practice, School of Pharmacy and Health Sciences, United States International University-Africa, Nairobi, Kenya, Nairobi, Kenya.
J Egypt Natl Canc Inst. 2025 Aug 4;37(1):53. doi: 10.1186/s43046-025-00309-8.
Aromatase inhibitors have demonstrated superior outcomes compared to tamoxifen in various studies. However, research in Africa, including Kenya, where breast cancer mortality rates are disproportionately high, is lacking.
The study aimed to assess the comparative efficacy of tamoxifen and aromatase inhibitors among hormone receptor-positive breast cancer patients at Kenyatta National Hospital.
A retrospective cohort study was conducted at the Oncology Department of Kenyatta National Hospital, involving all eligible hormone receptor-positive breast cancer patients treated in the facility between 1st January 2019 to 31st December 2022. The study was hospital-based and used a data abstraction tool to collect data from the patients' medical records. The data obtained was then analyzed using SPSS version 25 and Kaplan-Meier analysis was used to estimate the median survival time. Cox regression analysis was employed to determine whether there was a significant association between the variables. The collected data was presented in the form of frequency tables and graphs.
In our study, aromatase inhibitors consistently demonstrated superior outcomes compared to tamoxifen across various parameters. Specifically, aromatase inhibitors showed a lower incidence of disease progression (24% vs. 29.7%), a higher rate of complete radiological response (24% vs. 13.5%), and a reduced likelihood of developing distant metastasis while on treatment, coupled with a lower mortality rate (40% vs. 48.0%). Additionally, the median survival time for patients receiving aromatase inhibitors was notably longer at 49.0 months compared to 42.0 ± 3.6 months for those on tamoxifen (P = 0.410). Similarly, the aromatase inhibitor group exhibited a more extended median metastasis-free survival time (42.0 months vs. 30.0 ± 1.4 months, P = 0.056) and a more favorable survival time from metastasis to death (8 ± 0.6 months vs. 6 ± 0.8 months in the tamoxifen group, P = 0.142).
These findings collectively suggest a consistent trend towards improved treatment outcomes with aromatase inhibitors compared to tamoxifen. The observed reduction in mortality rates among aromatase inhibitor-treated patients highlights their potential clinical benefit, with superior overall survival and disease progression.
在各项研究中，芳香化酶抑制剂已显示出比他莫昔芬更优的治疗效果。然而，在非洲，包括肯尼亚，乳腺癌死亡率高得不成比例，这方面的研究却很缺乏。
本研究旨在评估在肯雅塔国家医院，他莫昔芬和芳香化酶抑制剂在激素受体阳性乳腺癌患者中的相对疗效。
在肯雅塔国家医院肿瘤科进行了一项回顾性队列研究，纳入了2019年1月1日至2022年12月31日期间在该机构接受治疗的所有符合条件的激素受体阳性乳腺癌患者。该研究以医院为基础，使用数据提取工具从患者病历中收集数据。然后使用SPSS 25版对获得的数据进行分析，并使用Kaplan-Meier分析来估计中位生存时间。采用Cox回归分析来确定变量之间是否存在显著关联。收集的数据以频率表和图表的形式呈现。
在我们的研究中，在各项参数方面，芳香化酶抑制剂始终显示出比他莫昔芬更优的治疗效果。具体而言，芳香化酶抑制剂显示疾病进展发生率较低（24%对29.7%），完全放射学缓解率较高（24%对13.5%），治疗期间发生远处转移的可能性降低，同时死亡率也较低（40%对48.0%）。此外，接受芳香化酶抑制剂治疗的患者中位生存时间明显更长，为49.0个月，而接受他莫昔芬治疗的患者为42.0±3.6个月（P = 0.410）。同样，芳香化酶抑制剂组的中位无转移生存时间更长（42.0个月对30.0±1.4个月，P = 0.056），从转移到死亡的生存时间更有利（芳香化酶抑制剂组为8±0.6个月，他莫昔芬组为6±0.8个月，P = 0.142）。
这些发现共同表明，与他莫昔芬相比，芳香化酶抑制剂在改善治疗效果方面呈现出一致的趋势。在接受芳香化酶抑制剂治疗的患者中观察到的死亡率降低突出了其潜在的临床益处，具有更好的总生存期和疾病进展情况。
