One AI versus another for 5 years

The mild androgen activity of exemestane prompted a randomized trial that evaluated whether exemestane might be preferable to anastrozole, in terms of its efficacy (i.e., EFS) and toxicity, as upfront therapy for postmenopausal women diagnosed with hormone receptor–positive breast cancer.[73][Level of evidence A1] The MA27 trial (NCT00066573) randomly assigned 7,576 postmenopausal women to receive 5 years of anastrozole or exemestane.

The mild androgen activity of exemestane prompted a randomized trial that evaluated whether exemestane might be preferable to anastrozole, in terms of its efficacy (i.e., EFS) and toxicity, as upfront therapy for postmenopausal women diagnosed with hormone receptor–positive breast cancer.[73][Level of evidence A1] The MA27 trial (NCT00066573) randomly assigned 7,576 postmenopausal women to receive 5 years of anastrozole or exemestane.

At a median follow-up of 4.1 years, no difference in efficacy was seen (HR, 1.02; 95% CI, 0.87–1.18; P = .86).[73][Level of evidence B1]

The mild androgen activity of exemestane prompted a randomized trial that evaluated whether exemestane might be preferable to anastrozole, in terms of its efficacy (i.e., EFS) and toxicity, as upfront therapy for postmenopausal women diagnosed with hormone receptor–positive breast cancer.[73][Level of evidence A1] The MA27 trial (NCT00066573) randomly assigned 7,576 postmenopausal women to receive 5 years of anastrozole or exemestane.

The two therapies also were not significantly different in terms of impact on bone mineral density or fracture rates.[74][Level of evidence B1]

In the Femara Versus Anastrozole Clinical Evaluation (FACE) study (NCT00248170), 4,136 patients with hormone receptor–positive disease were randomly assigned to receive either letrozole or anastrozole.[75]

In the Femara Versus Anastrozole Clinical Evaluation (FACE) study (NCT00248170), 4,136 patients with hormone receptor–positive disease were randomly assigned to receive either letrozole or anastrozole.[75]

There was no significant difference in DFS (HR, 0.93; 95% CI, 0.80–1.07; P = .3150) at the time of a final analysis that was conducted when there were 709 of the planned 959 events.

In the Femara Versus Anastrozole Clinical Evaluation (FACE) study (NCT00248170), 4,136 patients with hormone receptor–positive disease were randomly assigned to receive either letrozole or anastrozole.[75]

There were no substantial differences in adverse events between the arms.

In the FATA-GIM3 trial, 3,697 patients with hormone receptor–positive disease were randomly assigned among the three AIs either for 5 years or after 2 years of tamoxifen.[72]

In the FATA-GIM3 trial, 3,697 patients with hormone receptor–positive disease were randomly assigned among the three AIs either for 5 years or after 2 years of tamoxifen.[72]

No significant difference in 5-year DFS (90.0% for anastrozole, 88.0% for exemestane, and 89.4% for letrozole; P = .24) was noted among the three AIs.