Osteoporosis and aromatase inhibitors: experience and future prospects
In general, aromatase inhibitors are only used to treat breast cancer in postmenopausal women. Hormone therapy is recommended for a full five to 10 years after the primary treatment of breast cancer, so the cost of tamoxifen or your aromatase inhibitor is an important factor to consider. With some effort exploring your options, you may be able to significantly lower your overall spending on treatment. Hormone therapy with tamoxifen and/or an aromatase inhibitor is prescribed for 5-10 years. The length of treatment along with side effects, such as menopausal symptoms, can make it tough to complete treatment. Talk with your health care provider about ways to ease these and other side effects.
- It not only demonstrated superior clinical outcomes but also dominated palbociclib in terms of cost-effectiveness.
- Then the model was re-run to compare the ICERs among the three different CDK4/6 inhibitors plus letrozole in comparison to each other.
- Anastrozole and letrozole were both cost-effective treatments compared to tamoxifen.
AIs are classified as type 1 steroidal (noncompetitive, irreversible) or type 2 nonsteroidal (competitive, reversible) inhibitors. Exemestane, a type 1 inhibitor, binds irreversibly to the site on the aromatase molecule and is known as a suicide inhibitor. Median TTNT was 22.5months (95%CI 18.0–29.8), corresponding to a 1-year TTNT rate of 72.0% (95%CI 63.4–78.9) and a 2-year TTNT rate of 48.0% (95%CI 39.1–56.4) (Fig. 4). By the cut-off date, a total of 91 patients had discontinued palbociclib from any cause. Median TPF was 19.8 months (95%CI 14.2–24.9), corresponding to a 1-year TPF rate of 64.9% (95%CI 56.1–72.4) and a 2-year TPF rate of 41.8% (95%CI 33.3–50.1).
Dalpiciclib and pyrotinib in women with HER2-positive advanced breast cancer: a single-arm phase II trial
Many cancer centers have financial counselors who can discuss insurance and cost coverage with you. You may qualify for programs that help with drug costs or offer low-cost or free prescriptions. One may already be included in your policy, or you may be able to buy an extra plan for prescriptions. To learn about a specific aromatase inhibitor, visit the National Institutes of Health’s Medline Plus website. Aromasin offers may take the form of printable coupons, rebates, savings or copay cards, trial offers, or free samples. Certain offers may be printable from a website while others may require registration, completing a questionnaire, or obtaining a sample from a medical professional.
Study selection, assessment of risks of bias and data collection were conducted independently by two review authors without Post cycle therapy blinding. We dealt with missing information and data by making repeated attempts to contact the primary authors by email. Because we received no reply from them, continuous outcomes for which SDs were not reported were listed as in the original report.
Authors
With regards to abemaciclib, to our knowledge, there are only two studies that addressed its cost-effectiveness compared to other CDK4/6 inhibitors in advanced breast cancer, and both were carried out in the US. For the first one, the use of abemaciclib plus fulvestrant was not cost-effective compared to palbociclib plus fulvestrant (20). However, for the second one, abemaciclib was found to be cost-effective compared to ribociclib in the second-line treatment for HR+/HER2- advanced breast cancer in the US (21). However, to our knowledge, there are no yet thorough comparative cost-effectiveness evaluations comparing the three of the CDK4/6 inhibitors together in the same settings. According to a 2015 study in The Lancet, aromatase inhibitors are 30% more effective in preventing breast cancer recurrence and are able to decrease mortality rates by 15% after five years when compared to tamoxifen.
Further investigation is needed but there are challenges in designing appropriate clinical trials for a substance as variable as red wine. While there is insufficient evidence to advocate for red wine as an aromatase inhibitor, there is sufficient evidence to warrant further investigation. Several strategies were employed to investigate the benefit of AIs as an adjuvant treatment for hormone receptor-positive breast cancer in postmenopausal women. These strategies include upfront treatment with AIs, switching therapy to AIs after 2–3 years of tamoxifen, and extended AI therapy after the completion of tamoxifen for 5 years (Table 2). For the upfront strategy, there were three phase III clinical trials, namely ATAC 49, BIG 1–98 50, 51, and ABCSG-12 trial 52, comparing 5 years of anastrozole or letrozole to 5 years of tamoxifen.