Fulvestrant compared to aromatase inhibitors in post-menopausal women with HR+ advanced breast cancer

This study aimed to look at the safety and effectiveness of fulvestrant (Faslodex) compared to aromatase inhibitors in post-menopausal women with hormone receptor-positive (HR+) breast cancer. The authors found that fulvestrant was a safe and effective treatment in these patients when compared to aromatase inhibitors.

Breast cancer tumors can have hormone receptors for estrogen and progesterone. These can respond to treatment with drugs that target these receptors. Currently, aromatase inhibitors are the recommended drug treatment for these types of cancer. However, it is not known how well this works in comparison to fulvestrant.

This paper analyzed relevant research from around the world and pooled the results of 250 studies. A total of 3168 post-menopausal women with HR+ breast cancer were included in this analysis. Progression-free survival (PFS – survival after cancer treatment without any signs or symptoms) was measured and compared between treatments.

The study concluded that there was no difference seen in PFS between the women who took aromatase inhibitors and the women who took fulvestrant. The authors found that the women who took a higher dose of fulvestrant (500mg) had longer PFS compared to those who took the aromatase inhibitors.

Hot flushes and joint pain were seen with fulvestrant in 156 of the studies and with aromatase inhibitors in 164 studies. Low red blood cells (anemia) was seen with fulvestrant in 23 studies and aromatase inhibitors in 33 studies.

The study concluded that fulvestrant was safe, effective, and improved survival in post-menopausal women with HR+ breast cancer when compared to aromatase inhibitors. 

This review looked at many different studies. This means patients may not have been treated the same and this could have affected results.

If you are considering treatment options for HR+ advanced breast cancer, fulvestrant may be an option. Discuss this with your oncologist.