- The Washington Times - Monday, May 20, 2002

ORLANDO, Fla. (AP) A medical-research panel recommended yesterday that doctors stick with tamoxifen as the time-tested treatment for early stage breast cancer, despite evidence that newer drugs might do a better job of preventing recurrence.
The decision affects the care of about 700,000 women in the United States who take tamoxifen to prevent their breast cancer from returning.
Cancer physicians fielded many calls from patients in December after reports that a newer class of drugs, called aromatase inhibitors, appeared slightly more effective. Some quickly switched their patients, while many others wondered whether they should.
To help them decide, the American Society of Clinical Oncology (ASCO), the world's largest organization of cancer doctors, convened a panel to review the issue.
Their decision: It's too soon to change. In the end, the new drugs may prove superior, but it will take a few more years of study before doctors can be certain of their advantages as well as their potential risks.
"Clearly if the difference was very, very dramatic, that would color one's thinking, but the difference was small," said Dr. Eric Winer of Boston's Dana-Farber Cancer Institute. Dr. Winer was chairman of the 18-member panel that released the recommendations at the oncology society's meeting in Orlando. "It's proper caution to wait and see what happens before changing practice."
In December, researchers released the results of a head-to-head comparison of tamoxifen and an aromatase inhibitor called Arimidex in 9,366 women with early stage cancer. After 33 months of follow-up, 90 percent of women taking Arimidex were alive and free of cancer, compared with 88 percent on tamoxifen.
However, the panel concluded that since women typically take tamoxifen for five years, shorter trials may not fairly show tamoxifen's advantages. Furthermore, they said, there is no evidence so far that Arimidex improves women's survival.
"At this point, we would not recommend that doctors and patients start using this as the standard hormonal therapy in post-menopausal women," Dr. Winer said. "Give it two or three years, and we will be in a difference place."
Since Arimidex and other aromatase inhibitors are already on the market, doctors can use them in early stage breast cancer if they wish. AstraZeneca asked the Food and Drug Administration in February for formal approval of this use and expects an answer by August.

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