Fulvestrant for Advanced ER positive Breast Cancer

Fulvestrant (Faslodex®) - a competitive estrogen-receptor antagonist is relatively new class of endocrine treatment option in treatment of advanced breast cancer, besides commonly prescribed Tamoxifen (SERM - see reference) and Anastrozole (ARIMIDEX® - selective non-steroidal aromatase inhibitor). Approved in 2002 for use in post-menopausal estrogen receptor (ER) positive female with advanced metastatic breast cancer after failure of anti-estrogen therapy (i.e. tamoxifen), earlier studies (see Reference) clearly shown fulvestrant is as effective as anastrozole.

Recently published (Oct 2006)

Clinical implications:

• Investigate role of Fulvestrant as a first-line adjuvant endocrine therapy for metastatic breast cancer
• To study role of fulvestrant in delaying initiation of chemotherapy and associated side effects in endocrine resistant breast tumors

results of phase II Swiss Group for Clinical Cancer Research Trial (SAKK 21/00) stated significant clinical benefit in 30 % cases who had progressed despite prior aromatase inhibitor (AI) treatment. This benefit with fulvestrant was noted irrespective of response to an AI. Study concluded fulvestrant as a safe, well tolerated and effective therapy advanced metastatic breast cancer in post-menopausal patients with failure of anti-estrogen therapy and/or resistant to AI treatment.

Reference:
1. Journal Watch | Fulvestrant for Aromatase-Inhibitor–Resistant Breast Cancer
2. Fulvestrant clinical trials | PubMed PMID: 12177099, 15937908, 17030543
3. Prescription Information: Faslodex® | ARIMIDEX®
4. Selective estrogen receptor modulator (SERM) - Wikipedia article
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