Femara Beneficial After Tamoxifen in Breast Cancer

NEW YORK (Reuters Health) - Updated results from a large study reaffirm that women who take the drug Femara following 5 years of tamoxifen treatment for breast cancer are less likely to have a recurrence of the disease.

Treatment with Femara, known generically as letrozole, "should be discussed with all postmenopausal women completing standard adjuvant tamoxifen therapy," investigators write in the Journal of the National Cancer Institute.

Most breast cancer recurrences in women receiving 5 years of tamoxifen, the standard length of treatment, occur after 5 years. The trial that was designed to see if letrozole for 5 years after tamoxifen could further decrease the risk of late recurrences, was halted early after it became clear that the drug did indeed lengthen the time women survived free of disease.

The results of the final analysis released this week show that, after an average follow-up of 30 months, women taking letrozole compared with placebo had a 40 percent better chance of disease-free survival.

The final analysis also shows a "true improvement" in overall survival among women in the original trial whose cancer had spread to lymph nodes.

"The important aspect of this latter finding is not to suggest that now we know it is only good for node-positive patients, but that we know even better that it is good for all patients and that the node-positive findings suggest a survival advantage with longer treatment and further follow-up," lead investigator Dr. Paul E. Goss from Massachusetts General Hospital in Boston told Reuters Health.

With substantially longer follow-up, the final analysis also confirms that there are "no additional toxicities above those previously reported," Goss said. "In particular, no difference in the risk of a cardiovascular events or clinical osteoporotic fractures among women treated with letrozole."

The investigators are now actively recruiting women to an additional 5 years of Femara or placebo to determine exactly how long this medication should be continued.

SOURCE: Journal of the National Cancer Institute, September 7, 2005.