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Evidence summaries

Aromatase Inhibitors Versus Megestrol for Metastatic Breast Cancer

In patients with metastatic breast cancer not responsive to tamoxifen, aromatase inhibitors improve survival in comparison with megestrol. Level of evidence: "A"

A systematic review 1 including 3 RCTs with a total of 1 648 subjects was abstracted in DARE. Using the individual survival data derived from the original survival graphs, aromatase inhibitors significantly prolonged survival (relative risk of death 0.79; 95% Cl: 0.69 to 0.91). The analysis was performed on an intention to treat basis, with 803 patients treated with aromatase inhibitors and 845 patients treated with megestrol. The mean survival gain per patient was 4.1 months.

A retrospective non-randomised comparison between letrozole, anastrozole and exemestane showed better survival among exemestane- treated patients, followed by letrozole-treated patients, then anastrozole-treated patients. The megestrol group had a better survival pattern in the exemestane study, compared with the letrozole and anastrozole trial.

References

  • Messori A, Cattel F, Trippoli S, Vaiani M. Survival in patients with metastatic breast cancer: analysis of randomized studies comparing oral aromatase inhibitors versus megestrol. Anticancer Drugs 2000 Oct;11(9):701-6. [PubMed] [DARE]

Primary/Secondary Keywords