
The anastrozole [Arimidex]abstracts below have been edited.
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1. Gan To Kagaku Ryoho 2001 Apr;28(4):549-60 
<b>[Development of a novel aromatase inhibitor, anastrozole (Arimidex)--its basic and clinical studies]. [Article in Japanese]</b> 
Tsukagoshi S. 
Cancer Institute, Japanese Foundation for Cancer Research. 

"In US study compared anastrozole with tamoxifen, TTP with anastrozole is a significantly longer than that of tamoxifen (p = 0.005, two-sides). Anastrozole has shown to be at least as effective as tamoxifen, standard endocrine therapy for breast cancer, with good safety profiles." 
&&url PMID: 11329794


2. Curr Med Res Opin 2001;16(4):276-84 
<b>The Twenty-third Annual San Antonio Breast Cancer Symposium</b> 
Mokbel K. St George's Hospital, Blackshaw Road, London SW17 0QT, UK. kefahmokbel@hotmail.com  
"This paper reviews the recent Twenty-third Annual San Antonio Breast Cancer Symposium. ... fulvestrant (Falsodex), given as a once-monthly intramuscular injection (250 mg), was well-tolerated and at least as good as anastrozole (1 mg) in postmenopausal women with advanced breast cancer that had progressed or recurred on prior endocrine therapy. "
"Another phase III randomised trial found that letrozole (2.5 mg daily) was superior to tamoxifen as a neoadjuvant therapy in postmenopausal women with ER- and/or PgR-positive breast cancer unsuitable for breast-conserving surgery." 
&&url PMID: 11268712


3. Bull Cancer 2000 Dec;87 Spec No:31-39 
<b>[Aromatase inhibitors: a review of clinical trials]. [Article in French] </b>
Kerbrat P, Lefeuvre C. 
Departement d'oncologie medicale, Centre Eugene-Marquis, rue de la Bataille-Flandres-Dunkerque, CS 44229, 35042 Rennes Cedex, France. 

"new aromatase inhibitors have been synthetized; they belong to two groups: type I (formestane and exemestane) are steroidal irreversible and specific inhibitors, type II (anastrozole, letrozole and vorozole) are non steroidal reversible inhibitors, interfering with the aromatase heme. Several phase II and III trials demonstrated that these drugs are, at least, as active as aminoglutethimid or progestins in second line treatment, and are less toxic. Recently, an identical activity have been observed for anastrozole and tamoxifen in first line". 
&&url PMID: 11250606


4. Anticancer Drugs 2000 Oct;11(9):701-6 
<b>Survival in patients with metastatic breast cancer: analysis of randomized studies comparing oral aromatase inhibitors versus megestrol</b> 
Messori A, Cattel F, Trippoli S, Vaiani M. 
Laboratorio SIFO di Farmacoeconomia, Centro Informazione Farmaci, Azienda Ospedaliera Careggi, Florence, Italy. md3439@mclink.it  

"We conducted a meta-analysis to assess the effectiveness of aromatase inhibitors versus megestrol. ... A lifetime analysis of the pooled survival curves of aromatase inhibitors versus megestrol found a mean survival gain of 4.1 months per patient. Aromatase inhibitors confer a significant survival benefit to patients with metastatic breast cancer as compared with megestrol. 
&&url PMID: 11129731


5. Oncology 2000;59 Suppl 1:19-23 
<b>Gonadotropins stimulate growth of MCF-7 human breast cancer cells by promoting intracellular conversion of adrenal androgens to estrogens.</b> 
Tanaka Y, Kuwabara K, Okazaki T, Fujita T, Oizumi I, Kaiho S, Ogata E. 
Third Department of Internal Medicine, National Defense Medical College, Tokorozawa, Saitama, Japan. Copyright 2000 S. Karger AG, Basel

Resistance to estrogen ablation treatment can develop. 
&&url PMID: 11096352


6. J Clin Oncol 2000 Nov 15;18(22):3758-67 
<b>Anastrozole is superior to tamoxifen as first-line therapy for advanced breast cancer in postmenopausal women: results of a North American multicenter randomized trial.</b> 
Arimidex Study Group. Nabholtz JM, Buzdar A, Pollak M, Harwin W, Burton G, Mangalik A, Steinberg M, Webster A, von Euler M. 
Cancer-Cross Institute, Edmonton, Alberta, Canada. jean-marc.nabholtz@bcom 

"Both treatments were well tolerated. However, thromboembolic events and vaginal bleeding were reported in fewer patients who received anastrozole compared with those who received tamoxifen ... Anastrozole satisfied the predefined criteria for equivalence to tamoxifen. Furthermore, we observed both a significant increase in TTP and a lower incidence of thromboembolic events and vaginal bleeding with anastrozole. These findings indicate that anastrozole should be considered as first-line therapy for postmenopausal women with advanced breast cancer."
&&url PMID: 11078488 


7. Eur J Cancer 2000 Sep;36 Suppl 4:S84-5  
<b>Randomised study of anastrozole versus tamoxifen as first-line therapy for advanced breast cancer in postmenopausal women.</b> Vergote I, Bonneterre J, Thurlimann B, Robertson J, Krzakowski M, Mauriac L, Koralewski L, Webster A, Steinberg M, von Euler M. 
Department Gynaecological Oncology, University Hospitals Leuven, Herestraat 49, B3000, Leuven, Belgium. 

 "Anastrozole was also as effective as tamoxifen in terms of objective response-rate ... Both treatments were well tolerated. However, incidences of thromboembolic events and vaginal bleeding were reported in fewer patients treated with anastrozole than with tamoxifen. In conclusion, these findings indicate that anastrozole can be considered as first-line therapy for postmenopausal women with advanced breast cancer. " 
&&url PMID: 11056332


8. Anticancer Drugs 2000 Aug;11(7):591-601 
<b>Cost-utility analysis of second-line hormonal therapy in advanced breast cancer: a comparison of two aromatase inhibitors to megestrol acetate.</b> 
Dranitsaris G, Leung P, Mather J, Oza A. 
Department of Pharmacy, Ontario Cancer Institute/Princess Margaret Hospital, Toronto, Canada. gdranit@istar.ca 

"Randomized trials comparing the aromatase inhibitors, anastrozole and letrozole, to megestrol acetate (MA) in postmenopausal women with advanced breast cancer demonstrated that both agents are better tolerated than MA with comparable efficacy. In addition, one trial revealed that tumor response and time to treatment failure were significantly better with letrozole. " 
&&url PMID: 11036964 


9. Gynecol Oncol 2000 Aug;78(2):212-6
<b> A phase II trial of anastrozole in advanced recurrent or persistent endometrial carcinoma: a Gynecologic Oncology Group study.</b> 
Rose PG, Brunetto VL, VanLe L, Bell J, Walker JL, Lee RB. 
Department of Obstetrics and Gynecology, University Hospital of Cleveland, Ohio, 44106, USA. 

.... "Two partial responses were noted (9%; 90% confidence interval 3 to 23%). Two additional patients had short-term stable disease. With the exception of 1 case of venous thrombosis, the toxicity profile was mild. Median durations of progression-free survival and overall survival are 1 and 6 months, respectively" "Anastrozole has minimal activity in an unselected population of patients with recurrent endometrial cancer." Copyright 2000 Academic Press. 
&&url PMID: 10926805


10. Recent Results Cancer Res 1998;152:227-44 
<b>The primary use of endocrine therapies.</b> 
Howell A, Anderson E, Blamey R, Clarke RB, Dixon JM, Dowsett M, Johnston SR, Miller WR, Nicholson R, Robertson JF. 
CRC Department of Medical Oncology, Christie Hospital NHS Trust, Manchester, UK. 

"Primary endocrine therapy is potentially superior to primary chemotherapy in patients with ER-positive tumors. ... The fact that in ER-positive [BREAST] tumors primary endocrine therapy is associated with similar response rates to chemotherapy make it an attractive therapy for older women. ... This clinical scenario allows us to use other potentially useful assessments such as the non-invasive estimation of angiogenesis using quantitative imaging techniques of blood flow. The newer anti-estrogens and aromatase inhibitors appear ideally suited to primary therapy since they have rapid and profound inhibitory activities, few or no agonist effects, and low side effect profiles." 
&&url PMID: 9928561


11. J Steroid Biochem Mol Biol 1998 Nov;67(4):293-304 
<b>The steroidal antiestrogen ICI 182,780 is an inhibitor of cellular aromatase activity.</b> 
Long BJ, Tilghman SL, Yue W, Thiantanawat A, Grigoryev DN, Brodie AM. 
The University of Maryland School of Medicine, Baltimore 21201, USA. 

Two types of endocrine therapy that have been successfully applied to patients with hormone-dependent breast cancer are the non-steroidal antiestrogen tamoxifen, and inhibitors of aromatase, the enzyme that synthesizes estrogens.<b> The major drawback with tamoxifen is that it acts as a partial estrogen-agonist and this is believed to mediate, at least in part, acquired tumor resistance to the drug as well as endometrial hyperplasia and carcinoma in some patients. </b>
&&url PMID: 9883986 

  
12. Drugs Aging 1998 Oct;13(4):321-32 
<b>Anastrozole. A review of its use in the management of postmenopausal women with advanced breast cancer.</b> 
Wiseman LR, Adkins JC. Adis 
International Limited, Auckland, New Zealand. demail@adis.co.nz 

"...Anastrozole is generally well tolerated in the majority of patients, the most common adverse events being gastrointestinal (GI) disturbances (incidence 29 to 33%). These events are generally mild or moderate and transient. Other adverse events reported with anastrozole include headache (< or = 18%), asthenia (< or = 16%), pain (< or = 15%), hot flushes and bone pain (both < or = 12%), back pain and dyspnoea (both < or = 11%) and peripheral oedema (< or = 9%). GI disturbance tended to be more common with anastrozole than megestrol, particularly at the 10 mg/day dosage; however, compared with megestrol, anastrozole is less frequently associated with weight gain..."
&&url PMID: 9805213

  
13. Br J Cancer 1998 Sep;78 Suppl 4:12-5 
<b>Aromatase inhibitors and their future role in post-menopausal women with early breast cancer.</b> 
Lonning PE. 
Department of Therapeutic Oncology and Radiophysics, Haukeland University Hospital, Bergen, Norway. 

'In terms of benefits over other endocrine agents, anastrozole causes significantly less weight gain than megestrol acetate; it does not have the partial agonist activity of tamoxifen, and is unlikely to lead to tumour stimulation in patients resistant to tamoxifen or to exert proliferative effects on the endometrium. The lack of oestrogen agonist activity, however, may possibly have detrimental effects on bone mineral density and blood lipid profile.' 
&&url PMID: 9741783 


14. Cancer Epidemiol Biomarkers Prev 1998 Jan;7(1):65-78 
<b>Aromatase inhibitors as potential cancer chemopreventives.</b>
 Kelloff GJ, Lubet RA, Lieberman R, Eisenhauer K, Steele VE, Crowell JA, Hawk ET, Boone CW, Sigman CC.
 Chemoprevention Branch, Division of Cancer Prevention and Control, National Cancer Institute, Bethesda, Maryland 20852, USA. 

"one chemopreventive strategy for breast and prostate cancers is to decrease estrogen production. This can be accomplished by inhibiting aromatase, the enzyme that catalyzes the final, rate-limiting step in estrogen biosynthesis. .... The rationale for the use of aromatase inhibitors as chemopreventives and identification of inhibitors to serve as potential chemopreventive agents are the subjects of this review. .... The discussion focuses on those inhibitors that are clinically available or in clinical trials, including: aminoglutethimide (Cytadren), rogletimide, fadrozole hydrochloride, liarozole hydrochloride, anastrozole (Arimidex), letrozole, vorozole, formestane, exemestane, and atamestane. On the basis of results from preclinical studies, aromatase inhibitors may be promising agents for clinical trials in populations at high risk for developing estrogen-dependent cancers.Total suppression of aromatase may have adverse effects, as is evident in postmenopausal women (increased osteoporosis, cardiovascular disease, and urogenital atrophy). ...it may be possible to obtain chemopreventive effects without total suppression of aromatase and circulating estrogen levels. Suppressing local estrogen production may be an alternative strategy ...The development of drugs that target this promoter region may be possible. " 
&&url PMID: 9456245

  
15. Cancer 1997 Feb 15;79(4):730-9 
<b>A phase III trial comparing anastrozole (1 and 10 milligrams), a potent and selective aromatase inhibitor, with megestrol acetate in postmenopausal women with advanced breast carcinoma.</b> 
Arimidex Study Group. Buzdar AU, Jones SE, Vogel CL, Wolter J, Plourde P, Webster A.Department of Medical Oncology, M.D. Anderson Cancer Center, University of Texas Medical Center, Houston 77030, USA. 
&&url PMID: 9024711 


16. J Clin Oncol 1996 Jul;14(7):2000-11 
<b>Anastrozole, a potent and selective aromatase inhibitor, versus megestrol acetate in postmenopausal women with advanced breast cancer: results of overview analysis of two phase III trials. Arimidex Study Group.</b> 
Buzdar A, Jonat W, Howell A, Jones SE, Blomqvist C, Vogel CL, et.al
M.D. Anderson Cancer Center, University of Texas, Houston, 77030, USA.  
&&url PMID: 8683230 