Hormonal Therapy for Breast C... Video Transcript

Webcast Transcript

There was a study reported here at this meeting, a drug -- anastrozole, marketed as Arimidex -- that probably has a little bit less hot flashes.

We think all these drugs are going to produce less risk of things like blood clots and probably less risk of uterine cancer, which is one of the potential complications of tamoxifen therapy.

CATHY CONLEY: Dr. Goss, anything you'd like to add to that?

PAUL E. GOSS, MD: The anti-aromatase agents have no potential really serious side effects. This class of agents is extremely well-tolerated. Women can take these drugs with less side effect than a cholesterol-lowering drug. And actually, if we can divide them into two subsets, there's the so-called "nonsteroidal," and they just ablate estrogen and they cause aggravation of low estrogen state. So as a side effect profile, they have hot flashes, they have urogenital aggravation and things like that. There have the potential for osteoporosis and lipid-metabolism abnormalities.

On the other hand, we have the steroidal agent, which does the same thing in one way -- it knocks down estrogen the same. But because of its steroidal structure, it actually also possibly protects the bone and lipid levels. At first pass, it may seem like, "What's this got to do with breast cancer?" But if you've got a healthy woman, who's going to have prolonged therapy, protected her bones from accelerate osteoporosis is extremely important point, and it looks like these agents may be different in that regard.

CATHY CONLEY: There are three anti-aromatase agents on the market today. How do you go about choosing which one?

PAUL E. GOSS, MD: In terms of choosing anti-aromatase, we are spoiled. Because we've not only found a wonderful new class to help women, but we have three representatives within that class.

I think that we're going to see an evolution of data, and the clinicians are going to choose based on durable efficacy, better survival of patients -- obviously -- and better side effect profile. And my bets are on Aromasin-exemestane.

CATHY CONLEY: With all the new developments, what advice do you have for our viewers on our webcast?

PAUL E. GOSS, MD: Breast cancer patients need to hear the term "aromatase inhibitor" or "anti-aromatase agents." They need to be familiar with this, and they need to understand that there are three new drugs. The public know about tamoxifen, but they don't really know about this class of drugs. And they should go to the oncologist and they should discuss the new data.

CATHY CONLEY: Dr. Jones, your final comments?

STEPHEN E. JONES, MD: Well, I think that there's some very exciting results have been presented at this meeting. They're very preliminary, it's not yet time to give up tamoxifen as the gold standard. And we have to keep things in perspective: there's been 25 years with tamoxifen, there's hundreds of thousands of women's lives have been saved with tamoxifen and it's too soon to abandon that as the major hormonal strategy.

But I think these new anti-aromatase agents have the potential -- down the road, in the next two to five years -- of replacing tamoxifen, if the current studies are completed and they're -- and the results are shown to be as good as we expect they will be.

CATHY CONLEY: Dr. Stephen Jones, thank you so much for your time. Dr. Goss, we appreciate it very much.

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