[Extended adjuvant endocrine therapy in breast cancer]
Gonzalez L, Pichon-Riviere A, Augustovski F, García Martí S, Alcaraz A, Bardach A, Ciapponi A.
Record ID 32018001447
Spanish
Original Title:
Adyuvancia endocrina extendida en cáncer de mama
Authors' recommendations:
CONCLUSIONS
High-quality evidence shows that in postmenopausal women with hormone receptor-positive breast cancer who completed three to five years of treatment with tamoxifen, extended adjuvant endocrine therapy using aromatase inhibitors for another five years decreases the risk of contralateral breast cancer and increases disease free survival. This benefit is mainly observed in those women with positive lymph nodes and who are positive for both hormone receptors (estrogen and progesterone) at the time of diagnosis. No evidence supporting the initial use of aromatase inhibitors for 10 years has been found.
High-quality evidence indicates that the use of tamoxifen for 10 years in premenopausal women is associated to a mild decrease in the risk of death due to breast cancer and a moderate increase in the incidence of endometrial cancer and thromboembolic events.
There is consensus among the clinical practice guidelines and recommendations from the main international societies on continuing adjuvant endocrine therapy with aromatase inhibitors beyond 5 years with tamoxifen in all women with breast cancer, mainly when they show high risk of recurrence initially. Some of them also suggest assessing the use of 10 years of tamoxifen in premenopausal women case by case.
No cost-effectiveness or budget impact studies have been found in Latin America. An economic evaluation conducted in Canada concludes that extended adjuvant therapy is a cost-effective intervention. The coverage policies found cover the endocrine therapy with tamoxifen or aromatase inhibitors, but they do not mention the total length of treatment.
Details
Project Status:
Completed
Year Published:
2018
URL for published report:
https://www.iecs.org.ar/home-ets/
English language abstract:
An English language summary is available
Publication Type:
Not Assigned
Country:
Argentina
MeSH Terms
- Breast Neoplasms
- Adjuvants, Immunologic
- Antineoplastic Agents
- Aromatase Inhibitors
- Chemotherapy, Adjuvant
Contact
Organisation Name:
Institute for Clinical Effectiveness and Health Policy
Contact Address:
Dr. Emilio Ravignani 2024, Buenos Aires - Argentina, C1414 CABA
Contact Name:
info@iecs.org.ar
Contact Email:
info@iecs.org.ar
Copyright:
Institute for Clinical Effectiveness and Health Policy (IECS)
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.