weeks with concomitant quinapril being started four weeks after anastrozole. A pharmacokinetic study of the plasma concentration of anastrozole was performed on days 21, 28, 42, 56 and 70. The plasma anastrozole levels were compared between the two groups and showed no significant difference. In addition, hypertension was well controlled in all patients. There was no evidence of clinically significant drug–drug interaction between anastrozole and quinapril.34
In 2006, Carlini et al. reported a case of liver toxicity after treatment with gefitinib and anastrozole in a 63-year-old woman.35
hypothesised the possibility of drug–drug interactions through CYP450, but concluded that this interaction was unlikely as the pharmacokinetics of gefitinib are not altered by CYP3A4 inhibitors.36
In addition, this case report pointed out that in 2005 Polychronis et al. published a
1. American Cancer Society, Cancer Facts and Figures, 2009, American Cancer Society, Atlanta, GA, 2009. Available at: www.cancer.org/downloads/STT/500809web.pdf
(accessed 9 February 2009).
2. Buzdar A, Jonat W, Howell A, et al., 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, J Clin Oncol, 1996;14:2000–11.
3. Buzdar AU, Jonat W, Howell A, et al., Anastrozole versus megestrol acetate in the treatment of postmenopausal women with advanced breast carcinoma: results of a survival update based on a combined analysis of data from two mature phase III trials. Arimidex Study Group, Cancer, 1998;83:1142–52.
4. Kaufmann M, Bajetta E, Dirix LY, et al., Exemestane is superior to megestrol acetate after tamoxifen failure in postmenopausal women with advanced breast cancer: results of a phase III randomized double-blind trial. The Exemestane Study Group, J Clin Oncol, 2000;18:1399–411.
5. Nabholtz JM, Buzdar A, Pollak M, et al., Anastrozole is superior to tamoxifen as first-line therapy for advanced breast cancer in postmenopausal women: results of a North American multicenter randomized trial. Arimidex Study Group, J Clin Oncol, 2000;18:3758–67.
6. Baum M, Budzar AU, Cuzick J, et al., Anastrozole alone or in combination with tamoxifen versus tamoxifen alone for adjuvant treatment of postmenopausal women with early breast cancer: first results of the ATAC randomised trial, Lancet, 2002;359:2131–9.
7. Coombes RC, Hall E, Gibson LJ, et al., A randomized trial of exemestane after two to three years of tamoxifen therapy in postmenopausal women with primary breast cancer, N Engl J Med, 2004;350:1081–92.
8. Goss PE, Ingle JN, Martino S, et al., A randomized trial of letrozole in postmenopausal women after five years of tamoxifen therapy for early-stage breast cancer, N Engl J Med, 2003;349:1793–802.
9. Breast International Group (BIG) 1-98 Collaborative Group, Thürlimann B, Keshaviah A, Coates AS, et al., A comparison of letrozole and tamoxifen in postmenopausal women with early breast cancer, N Engl J Med, 2005;353:2747–57.
10. Boccardo F, Rubagotti A, Puntoni M, et al., Switching to anastrozole versus continued tamoxifen treatment of early breast cancer: preliminary results of the Italian Tamoxifen Anastrozole Trial, J Clin Oncol, 2005;23:5138–47.
11. Winer EP, Hudis C, Burstein HJ, et al., American Society of Clinical Oncology technology assessment on the use of aromatase inhibitors as adjuvant therapy for postmenopausal women with hormone receptor-positive breast cancer: status report 2004, J Clin Oncol, 2005;23:619–29.
12. Wells SA Jr, Santen RJ, Lipton A, et al., Medical adrenalectomy
randomised controlled trial comparing preoperative gefitinib versus gefitinib and anastrozole in treating 56 post-menopausal patients with oestrogen-receptor-positive, epidermal growth factor-receptor-positive breast cancer. Polychronis et al. reported that there was no effect of anastrozole on the pharmacokinetics of gefitinib, although data were not shown.37
Anastrozole is a potent non-steroidal AI that selectively inhibits aromatase. It is the first AI approved by the FDA as an adjuvant hormonal therapy in early-stage breast cancer. The standard dose of anastrozole is 1mg/day orally. There have been no significant drug–drug interactions between anastrozole and other drugs reported to date. n
with aminoglutethimide: clinical studies in postmenopausal patients with metastatic breast carcinoma, Ann Surg, 1978;187:475–84.
13. Lønning PE, Kvinnsland S, Mechanisms of action of aminoglutethimide as endocrine therapy of breast cancer, Drugs, 1988;35:685–710.
14. MacNeill FA, Jones AL, Jacobs S, et al., The influence of aminoglutethimide and its analogue rogletimide on peripheral aromatisation in breast cancer, Br J Cancer, 1992;66:692–7.
15. Dowsett M, MacNeill F, Mehta A, et al., Endocrine, pharmacokinetic and clinical studies of the aromatase inhibitor 3-ethyl-3-(4-pyridyl)piperidine-2,6-dione (‘pyridoglutethimide’) in postmenopausal breast cancer patients, Br J Cancer, 1991;64:887–94.
16. Steele RE, Mellor LB, Sawyer WK, et al., In vitro and in vivo studies demonstrating potent and selective estrogen inhibition with the nonsteroidal aromatase inhibitor CGS 16949A, Steroids, 1987;50:147–61.
17. Dowsett M, Stein RC, Mehta A, et al., Potency and selectivity of the non-steroidal aromatase inhibitor CGS 16949A in postmenopausal breast cancer patients, Clin Endocrinol (Oxf), 1990;32:623–34.
18. Buzdar AU, Robertson JF, Eiermann W, et al., An overview of the pharmacology and pharmacokinetics of the newer generation aromatase inhibitors anastrozole, letrozole, and exemestane, Cancer, 2002;95:2006–16.
19. Baum M, Budzar AU, Cuzick J, et al., ATAC Trialists’ Group, Anastrozole alone or in combination with tamoxifen versus tamoxifen alone for adjuvant treatment of postmenopausal women with early breast cancer: first results of the ATAC randomised trial, Lancet, 2002;359:2131–9.
20. Baum M, Buzdar A, Cuzick J, et al., Anastrozole alone or in combination with tamoxifen versus tamoxifen alone for adjuvant treatment of postmenopausal women with early- stage breast cancer: results of the ATAC (Arimidex, Tamoxifen Alone or in Combination) trial efficacy and safety update analyses, Cancer, 2003;98:1802–10.
21. Center AN, Drug To Prevent Breast Cancer Recurrence Gets FDA Approval, 2002. Available at: www.cancer.org/docroot/
22. Lønning PE, Geisler J, Dowsett M, Pharmacological and clinical profile of anastrozole, Breast Cancer Res Treat, 1998;49(Suppl. 1):S53–7, discussion S73–7.
23. Yates RA, Dowsett M, Fisher GV, et al., Arimidex (ZD1033): a selective, potent inhibitor of aromatase in postmenopausal female volunteers, Br J Cancer, 1996;73:543–8.
24. Jonat W, Howell A, Blomqvist C, et al., A randomised trial comparing two doses of the new selective aromatase inhibitor anastrozole (Arimidex) with megestrol acetate in
postmenopausal patients with advanced breast cancer, Eur J Cancer, 1996;32A:404–12.
25. Buzdar AU, Jones SE, Vogel CL, et al., 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. Arimidex Study Group, Cancer, 1997;79:730–9.
26. Plourde PV, Dyroff M, Dukes M, Arimidex: a potent and selective fourth-generation aromatase inhibitor, Breast Cancer Res Treat, 1994;30:103–11.
27. Chu E, DeVita VT, Physicians’ Cancer Chemotherapy Drug Manual, Sudbury, MA, Jones and Bartlett Publishers, 2008.
28. AstraZeneca, ARIMIDEX (anastrozole tablets) package insert, 2005.
29. Geisler J, King N, Dowsett M, et al., Influence of anastrozole (Arimidex), a selective, non-steroidal aromatase inhibitor, on in vivo aromatisation and plasma oestrogen levels in postmenopausal women with breast cancer, Br J Cancer, 1996;74:1286–91.
30. Grimm SW, Dyroff MC, Inhibition of human drug metabolizing cytochromes P450 by anastrozole, a potent and selective inhibitor of aromatase, Drug Metab Dispos, 1997;25:598–602.
31. Dowsett M, Cuzick J, Howell A, et al., Pharmacokinetics of anastrozole and tamoxifen alone, and in combination, during adjuvant endocrine therapy for early breast cancer in postmenopausal women: a sub-protocol of the ‘Arimidex and tamoxifen alone or in combination’ (ATAC) trial, Br J Cancer, 2001;85:317–24.
32. Bao T, Slater SA, Blackford B, et al., Effect of simvastatin on the pharmacokinetics of anastrozole, J Clin Oncol, 2009;27:15s, abstract 1517.
33. Yates RA, Wong J, Seiberling M, et al., The effect of anastrozole on the single-dose pharmacokinetics and anticoagulant activity of warfarin in healthy volunteers, Br J Clin Pharmacol, 2001;51:429–35.
34. Repetto L, Vannozzi O, Hazini A, et al., Anastrozole and quinapril can be safely coadministered to elderly women with breast cancer and hypertension: a pharmacokinetic study, Ann Oncol, 2003;14:1587–8.
35. Carlini P, Papaldo P, Fabi A, et al., Liver toxicity after treatment with gefitinib and anastrozole: drug-drug interactions through cytochrome p450?, J Clin Oncol, 2006;24:e60–1.
36. Swaisland HC, Ranson M, Smith RP, et al., Pharmacokinetic drug interactions of gefitinib with rifampicin, itraconazole and metoprolol, Clin Pharmacokinet, 2005;44:1067–81.
37. Polychronis A, Sinnett HD, Hadjiminas D, et al., Preoperative gefitinib versus gefitinib and anastrozole in postmenopausal patients with oestrogen-receptor positive and epidermal- growth-factor-receptor-positive primary breast cancer: a double-blind placebo-controlled phase II randomised trial, Lancet Oncol, 2005;6:383–91.
EUROPEAN ONCOLOGY & HAEMATOLOGY
| Page 2
| Page 3
| Page 4
| Page 5
| Page 6
| Page 7
| Page 8
| Page 9
| Page 10
| Page 11
| Page 12
| Page 13
| Page 14
| Page 15
| Page 16
| Page 17
| Page 18
| Page 19
| Page 20
| Page 21
| Page 22
| Page 23
| Page 24
| Page 25
| Page 26
| Page 27
| Page 28
| Page 29
| Page 30
| Page 31
| Page 32
| Page 33
| Page 34
| Page 35
| Page 36
| Page 37
| Page 38
| Page 39
| Page 40
| Page 41
| Page 42
| Page 43
| Page 44
| Page 45
| Page 46
| Page 47
| Page 48
| Page 49
| Page 50
| Page 51
| Page 52
| Page 53
| Page 54
| Page 55
| Page 56
| Page 57
| Page 58
| Page 59
| Page 60
| Page 61
| Page 62
| Page 63
| Page 64
| Page 65
| Page 66
| Page 67
| Page 68