Most Read Articles
Pearl Toh, 11 Oct 2017
Clinical practice is an art guided by good science, and clinical practice guideline (CPG) is meant to guide in integrating the art and science of clinical practice for the long-term benefits of patients, said Dr Abdul Rashid Abdul Rahman, a consultant cardiovascular physician at An-Nur Specialist Hospital in Bangi, Malaysia, during the 13th Asian-Pacific Congress of Hypertension (APCH) held in Singapore.
08 Oct 2017
Treatment with vismodegib does not appear to increase the risk of subsequent squamous cell carcinoma (SCC) in comparison with standard surgical treatment of basal cell carcinoma (BCC), a recent study suggests.
01 Sep 2017
Complementary medicines can play an important part in maintaining wellness, preventing deficiencies and optimizing health outcomes, says Dr Lesley Braun PhD, Director of the Blackmores Institute. 
Pearl Toh, 06 Oct 2017
Bacillus Calmette-Guérin (BCG) vaccination is not associated with any changes in the risk of developing childhood asthma, suggesting that any associations previously reported may be attributed to confounding factors, according to the QBCIH* study.

Fulvestrant, letrozole best first-line endocrine therapy for advanced breast cancer

22 Sep 2017

Fulvestrant and letrozole seem to be the optimal first-line endocrine therapy choices for hormone receptor-positive (HR+) and human epidermal growth factor receptor-2-negative (HER2-) advanced breast cancer (ABC), according to a network meta-analysis.

The meta-analysis included 27 articles of eight randomized controlled trials (RCTs) corresponding to 3,492 ABC patients. Six monotherapies were investigated: anastrozole, fulvestrant, tamoxifen, exemestane and lestrozole; doses of 250 and 500 mg were considered.

Letrozole yielded better objective response rate (ORR) than tamoxifen (odds ratio [OR], 0.59; 95 percent CI, 0.43 to 0.80) and fulvestrant (OR, 0.54; 0.34 to 0.85) at 250 mg. Exemestane also produced better ORR than fulvestrant (OR, 0.61; 0.37 to 0.97) and tamoxifen (OR, 0.67; 0.48 to 0.91) at 250 mg.

In terms of survival, only one study reported on progression-free survival (PFS) while most looked at time to progression (TTP).  In terms of TTP/PFS, tamoxifen was less effective than both anastrozole (hazard ratio [HR], 0.84; 0.72 to 0.99) and letrozole (HR, 0.70; 0.60 to 0.81).

In comparison, anastrozole (HR, 0.72; 0.56 to 0.93), exemestane (HR, 0.75; 0.57 to 0.97) and letrozole (HR, 0.60; 0.46 to 0.76) all had better TTP/PFS than fulvestrant.

Fulvestrant at 500 mg yielded better TTP/PFS than 250 mg of anastrozole (HR, 1.54; 1.09 to 2.11), exemestane (HR, 1.61; 1.08 to 2.25), tamoxifen (HR, 1.84; 1.24 to 2.55) and fulvestrant (HR, 2.17; 1.34 to 3.11). Only letrozole was not inferior to 500 mg fulvestrant.

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Most Read Articles
Pearl Toh, 11 Oct 2017
Clinical practice is an art guided by good science, and clinical practice guideline (CPG) is meant to guide in integrating the art and science of clinical practice for the long-term benefits of patients, said Dr Abdul Rashid Abdul Rahman, a consultant cardiovascular physician at An-Nur Specialist Hospital in Bangi, Malaysia, during the 13th Asian-Pacific Congress of Hypertension (APCH) held in Singapore.
08 Oct 2017
Treatment with vismodegib does not appear to increase the risk of subsequent squamous cell carcinoma (SCC) in comparison with standard surgical treatment of basal cell carcinoma (BCC), a recent study suggests.
01 Sep 2017
Complementary medicines can play an important part in maintaining wellness, preventing deficiencies and optimizing health outcomes, says Dr Lesley Braun PhD, Director of the Blackmores Institute. 
Pearl Toh, 06 Oct 2017
Bacillus Calmette-Guérin (BCG) vaccination is not associated with any changes in the risk of developing childhood asthma, suggesting that any associations previously reported may be attributed to confounding factors, according to the QBCIH* study.