Doctors advised not to switch to newer breast cancer drugs

Associated Press

ORLANDO, Fla. — An expert panel recommended Sunday that doctors stick with tamoxifen as the time-tested treatment for early stage breast cancer, despite evidence that newer drugs may do a better job of preventing recurrence.

The decision affects the care of an estimated 700,000 women in the United States who take tamoxifen to prevent their breast cancer from coming back.

Cancer physicians fielded many calls from patients last December after reports that a newer class of drugs, called aromatase inhibitors, appear slightly more effective. Some quickly switched their patients, while many others wondered whether they should.

To help them decide, the American Society of Clinical Oncology, the world’s largest organization of cancer doctors, convened an expert panel to review the issue.

Their decision: It’s too soon to change. In the end, the new drugs may prove superior, but it will take a few more years of study before doctors can be certain of their advantages as well as their possible risks.

"Clearly if the difference was very, very dramatic, that would color one’s thinking, but the difference was small," said Dr. Eric Winer, who chaired the 18-member panel. "It’s proper caution to wait and see what happens before changing practice."

In December, researchers released the results of a head-to-head comparison of tamoxifen and an aromatase inhibitor called Arimidex in 9,366 women with early stage cancer. After 33 months of follow-up, 90 percent of women getting Arimidex were alive and free of cancer, compared with 88 percent on tamoxifen.

However, women typically take tamoxifen for five years. So the panel concluded that results after less than three years may not fairly show tamoxifen’s advantages. Furthermore, they said, there is no evidence so far that Arimidex improves women’s survival.

Copyright ©2002 Associated Press. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.

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