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FEMARA
(Generic name: Toremifene) |
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Reviews |
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Femara |
Clin Cancer Res. 2005 Jan 15;11(2 Pt
2):900s-5s.
Endocrine therapy trials of aromatase inhibitors for
breast cancer in the adjuvant and prevention settings.
Ingle JN.
Division of Medical Oncology, Mayo Clinic, Rochester, Minnesota, 55905,
USA.
The recent past has witnessed the appearance of substantial data relating
to endocrine therapy of breast cancer. In the adjuvant therapy setting in
early breast cancer, several large, well-conducted, randomized, double-blind
clinical trials have provided evidence for the value of the third-generation
aromatase inhibitors (AI) anastrozole, exemestane, and letrozole. The three
major studies to date [i.e., Arimidex, tamoxifen alone, or in combination
(ATAC), International Exemestane Study (IES), and letrozole after 5 years
of tamoxifen (MA.17)] evaluated three different populations of women from
the standpoints of duration of prior tamoxifen and thus time since the treatment
of the primary breast cancer. A consistent pattern of improvement in disease-free
survival was seen whether the control arm was tamoxifen (ATAC and IES) or
placebo following tamoxifen (MA.17). From a toxicity standpoint, the major
findings with the AIs were a decreased incidence of thromboembolic events
and endometrial cancers but an increase in musculoskeletal complaints and
potential for decreasing bone density. The last issue should be clarified
with ongoing studies addressing the impact of the three AIs on bone density
and fractures. In summary, based on ATAC, IES, and MA.17, respectively,
the following conclusions can be drawn relating to postmenopausal women
with hormone receptor positive early breast cancer: anastrozole is a reasonable
choice for initial endocrine adjuvant therapy, exemestane should be considered
for women who have received 2 to 3 years of tamoxifen, and letrozole should
be considered for those who have completed about 5 years of tamoxifen.In
the prevention setting, tamoxifen has been evaluated in multiple trials
involving >28,000 women and, despite clear evidence of benefit, the level
of acceptance of this agent by women seems to be low. Two recently developed
prevention trials, IBIS 2 and MAP.3, involve the study of aromatase inhibitors
against a placebo control rather than tamoxifen. Whereas the recent adjuvant
trials have established the value of the third-generation aromatase inhibitors
in early-stage breast cancer, the marked reductions in contralateral breast
cancers seen in these trials suggest they will be of value in the prevention
setting in women at increased risk of developing the disease.
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Pediatrics. 2005 Feb;115(2):e245-8.
Epub 2005 Jan 14.
Letrozole significantly improves growth potential
in a pubertal boy with growth hormone deficiency.
Zhou P, Shah B, Prasad K, David R.
Division of Pediatric Endocrinology, New York University School of
Medicine, New York, New York 10016, USA.
Clinical experience with using an aromatase inhibitor to suppress estrogen
production during puberty for improvement of growth potential in adolescents
with short stature is limited. This report documents treatment of such
a patient with a combination of growth hormone and letrozole, a third-generation
aromatase inhibitor. Our case demonstrates a favorable outcome on a short-term
basis. |
Semin Oncol. 2004 Dec;31(6 Suppl
12):31-4.
Aromatase inhibitors in the management of early breast
cancer: optimizing the clinical benefit.
Henderson IC.
University of California, San Francisco Comprehensive Cancer Center,
San Francisco, CA 94123, USA.
Several adjuvant trials evaluating aromatase inhibitors in postmenopausal
women with early breast cancer have shown significant improvement upon,
or extension of the efficacy benefits of, standard therapy with tamoxifen,
and treatments were generally well tolerated. Disease-free survival was
significantly improved by: anastrozole versus tamoxifen for 5 years of
adjuvant therapy, in the Arimidex, Tamoxifen Alone or in Combination trial;
switching to exemestane after 2 to 3 years of tamoxifen, compared with
remaining on tamoxifen for 5 years, in the Intergroup Exemestane Study;
and switching to letrozole (v placebo) for 5 years after 5 years of tamoxifen,
in the extended adjuvant trial, MA.17. Further analyses of these trials,
and data from ongoing trials, will address how to optimally use aromatase
inhibitors in the adjuvant breast cancer setting: whether these agents
should be used in place of, or sequenced with, tamoxifen; what is the
best order of sequencing, before or after tamoxifen, and when is the best
time to switch; what the long-term safety issues are associated with aromatase
inhibitor treatment; and how toxicities can be effectively managed. |
Semin Oncol. 2004 Dec;31(6 Suppl 12):23-30.
Optimizing bisphosphonate therapy in patients with breast
cancer on endocrine therapy.
Harvey HA.
Penn State Milton S. Hershey Medical Center, Hershey, PA 17033,
USA.
Deterioration of bone health is a major concern during progression and treatment
of patients with breast cancer, especially in postmenopausal women. Disease-
and treatment-associated skeletal-related events include fractures, spinal
compression, bone pain, and hypercalcemia of malignancy. Bisphosphonates,
which inhibit osteoclastic bone resorption, are important new agents in
the management of skeletal-related events, and their impact on breast cancer-related
bone metastases and on bone loss during long-term estrogen deprivation therapies
such as aromatase inhibitors is reviewed. Intravenous pamidronate has become
the standard bisphosphonate to reduce or delay skeletal complications of
advanced breast cancer bone metastases, but the more potent agent, zoledronic
acid, appears to be at least as effective. Another agent, ibandronate, is
also active but has not been investigated in comparison with the other intravenous
bisphosphonates. Zoledronic acid is the most convenient to administer, requiring
only a short infusion. The effects of bisphosphonates on bone health in
women with early breast cancer are also being investigated. A single yearly
infusion of zoledronic acid has been shown to significantly increase bone
mineral density in osteoporotic postmenopausal women and to reduce biochemical
markers of bone turnover. The possibility of such treatment-reversing aromatase
inhibitor-associated bone loss during adjuvant therapy of breast cancer
is being evaluated in a trial of letrozole, with zoledronic acid added initially
or after the onset of bone loss or fracture. |
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Drug information |
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| GENERIC NAME: letrozole
BRAND NAME: Femara
DRUG CLASS AND MECHANISM: Letrozole is an oral, anti-estrogen
drug that is used for treating postmenopausal women with breast cancer.
The growth of some breast cancers in postmenopausal women is promoted
by estrogens that circulate in the blood, and the adrenal glands are the
main source of these circulating estrogens. Letrozole inhibits the enzyme
in the adrenal glands (aromatase) that produces the estrogens, estradiol
and estrone. Letrozole was approved by the FDA in 1997.
PREPARATIONS: Tablets: 2.5mg.
STORAGE: Tablets should be stored at room temperature,
15-30 °C (59-86 °F).
PRESCRIBED FOR: Letrozole is used to treat postmenopausal
women with breast cancer that is resistant to the more commonly-used anti-estrogen
medications such as tamoxifen (Nolvadex).
DOSING: Letrozole generally is taken once daily, with
or without food.
DRUG INTERACTIONS: There are no known drug interactions
with letrozole.
PREGNANCY: Letrozole damages the fetus. It should not
be taken by pregnant women.
NURSING MOTHERS: It is not known if letrozole is secreted
into breast milk.
SIDE EFFECTS: The most common side effects with letrozole
are nausea, vomiting, fatigue, headache, muscle aches, diarrhea, constipation,
and chest pain. The likelihood of side effects is lower than with other
drugs used more commonly in patients with breast cancer that is resistant
to treatment with anti-estrogens, for example, megestrol (Megace). Glossary
content Copyright © 1996-2002 MedicineNet, Inc. All rights reserved.
Caution! Before starting
to take this medicine, it is vital that you should consult your doctor!
Do not use it on your own initiative, without medical advice.
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Order now ! |
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FEMARA
(Generic name: letrozole)
Breast cancer
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Dosage |
Packing |
Price |
Pay now |
2.5 mg |
30 tab |
USD 319.00 |
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