New breast cancer drug improves recurrence rates

January 3rd 2006

Campaigners stepped up pressure for England to recognise a new breast cancer drug after research showed it was more effective than tamoxifen.

Research published yesterday (29 December) shows that one of the new drugs, letrozole (marketed as Femara by drug company Novartis), led to better outcomes than tamoxifen when given after surgery.

The National Institute for Health and Clinical Excellence is due to deliver a ruling on the use of letrozole and other aromatase inhibitors in the autumn.

The drug is already licensed in the UK for treatment of postmenopausal women after surgery for early breast cancer. But a NICE ruling is likely to determine whether the NHS offers the drug.

Cancer specialist Professor Karol Sikora, of Hammersmith Hospital, London, said: "What we need is to see a really slick version of NICE that can approve a drug within two days.

"There is going to be no more data when they finally approve it than they have got now - and that is the tragedy."

The study was done by the Breast International Group and involved 8,010 women in 29 countries, including the UK. The women were given different combinations of letrozole and tamoxifen over a five year period.

After an average of 26 months, there was a 19 per cent reduction in the risk of recurring cancers for all the women on tamoxifen than on letrozole.

Among women whose cancer had spread to their lymph nodes, there were 29 per cent fewer cases of recurring cancer on letrozole compared with tamoxifen. In those who had also needed chemotherapy, there were 28 per cent fewer cases of recurring cancer.

Results are published in the New England Journal of Medicine.

The researchers conclude: "In postmenopausal women with endocrine-responsive breast cancer, adjuvant treatment with letrozole, as compared with tamoxifen, reduced the risk of recurrent disease, especially at distant sites."

Many trials have now shown significant improvements on drugs such as letrozole from the new class called aromatase inhibitors. Further research will determine which drug treatment is best for each subgroup of breast cancer, but now doctors must brace themselves against pressure to prescribe these newer drugs.

N Engl J Med 353: pp 2747-57, 2807-09

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