ONCOLOGY * Letrozole Therapy for Breast Cancer Goss PE, Ingle JN, Martina S, et al: A randomized trial ofletrozole in postmenopausal women after five years of tamoxifen therapy for early-stage breast cancer. N Engl J Med 2003;349(19): 1793-802.
Bryant J, Wolmark N: Letrozole after tamoxifen for breast cancer- what is the price of success? N Engl J Med 2003;349l19):1855-57 (editorial).
Burstein HF: Beyond tamoxifen-extending endocrine treatment for early-stage breast cancer. N Engl J Med 2003;349(WI: 1857-59 (editorial).
In hormone-dependent breast cancer, 5 years of postoperative treatment with tamoxifen, an antagonist of the estrogen receptor, prolongs disease-free and overall survival, but more than 5 years of therapy does not provide added benefit. Goss and coauthors investigated the benefits of extended therapy with the aromatase inhibitor letrozole, which suppresses estrogen production. More than 5,000 women were recruited and an interim analysis was conducted after a median of 2.4 years of follow-up. There were 207 local or metastatic recurrences of breast cancer or new primary cancers, 75 in the letrozole group and 132 in the placebo group, with an estimated 4-year disease-free survival rate of 93% and 87% respectively (p
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