Effects of anastrozole: A Synthesis of Findings from 21 Studies

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Original Abstract of the Article

Main Research Findings

Anastrozole is an aromatase inhibitor, a type of drug that reduces the production of estrogen in the body. Several studies have shown that anastrozole is an effective treatment for postmenopausal women with early-stage breast cancer. 4 13 9 Anastrozole has been found to be more effective and better tolerated than tamoxifen, another common breast cancer treatment. 13 9 20 Anastrozole, when used in combination with tamoxifen, does not affect the way tamoxifen works in the body. 1 Additionally, anastrozole continues to suppress estrogen levels effectively even when given with tamoxifen. 1 Anastrozole is generally well-tolerated, with side effects similar to those seen with placebo. 1 However, some research suggests that anastrozole may increase the risk of bone pain and joint pain compared to tamoxifen. 20 Anastrozole may cause a decrease in bone mineral density, which can lead to an increased risk of fractures. 14 21 However, this decline is often modest and can be partially reversed after stopping anastrozole. 21

Benefits and Risks

Benefit Summary

Anastrozole is a more effective and well-tolerated treatment option for postmenopausal women with early-stage breast cancer than tamoxifen. 13 9 20 It has been shown to extend disease-free survival, reduce recurrence rates, and improve overall survival compared to tamoxifen. 20 13 Anastrozole can be used effectively in combination with tamoxifen without interfering with tamoxifen’s function. 1

Risk Summary

Anastrozole may increase the risk of bone pain and joint pain compared to tamoxifen. 20 Anastrozole may cause a decrease in bone mineral density, which can lead to an increased risk of fractures. 14 21

Comparison Between Studies

Similarities Between Studies

Many studies have shown that anastrozole is an effective treatment for postmenopausal women with early-stage breast cancer. 4 9 13 These studies have also consistently found that anastrozole can extend disease-free survival, reduce recurrence rates, and improve overall survival compared to tamoxifen. 13 20

Differences Between Studies

Some studies have shown that anastrozole may increase the risk of bone pain and joint pain compared to tamoxifen, while other studies haven’t shown this difference. 20 13 These differences could be attributed to factors such as study design, patient population, and evaluation methods.

Consistency and Contradictions in the Results

Anastrozole is a well-established effective treatment option for postmenopausal women with early-stage breast cancer. 4 9 13 However, research on the risk of bone pain and joint pain with anastrozole, compared to tamoxifen, has shown inconsistencies. 20 13 These inconsistencies could be explained by differences in study design, patient population, or evaluation methods used in the research.

Important Considerations for Real-Life Application

Anastrozole is a beneficial treatment option for postmenopausal women with early-stage breast cancer, but it is important to consider its potential side effects, such as bone pain, joint pain, and a decreased bone mineral density. 20 14 21 It is crucial to discuss these potential risks with your healthcare provider before starting anastrozole treatment.

Limitations of Current Research

There are inconsistencies in the research findings regarding the risk of bone pain and joint pain associated with anastrozole, compared to tamoxifen. 20 13 These discrepancies may be due to differences in study design, patient population, or evaluation methods.

Future Research Directions

To resolve the inconsistencies in the research findings regarding the risk of bone pain and joint pain associated with anastrozole, compared to tamoxifen, larger and more rigorous clinical trials with standardized designs are needed. 20 13

Conclusion

Anastrozole is a proven effective treatment option for postmenopausal women with early-stage breast cancer. 4 9 13 However, it’s important to consider its potential side effects, such as bone pain, joint pain, and a decreased bone mineral density. 20 14 21 It is crucial to discuss these potential risks with your healthcare provider before starting anastrozole treatment.

Literature analysis of 21 papers
Positive Content
21
Neutral Content
0
Negative Content
0
Article Type
17
4
2
2
21
1.

The effect of anastrozole on the pharmacokinetics of tamoxifen in post-menopausal women with early breast cancer.

Author: DowsettM, TobiasJ S, HowellA, BlackmanG M, WelchH, KingN, PonzoneR, von EulerM, BaumM

Oestradiol Suppression

Anastrozole, an aromatase inhibitor, did not affect the pharmacokinetics of tamoxifen when given together to postmenopausal women with breast cancer. Anastrozole remained effective in suppressing oestradiol levels even in the presence of tamoxifen.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

2.

A randomized, open, parallel-group trial to compare the endocrine effects of oral anastrozole (Arimidex) with intramuscular formestane in postmenopausal women with advanced breast cancer.

Author: VorobiofD A, KleebergU R, Perez-CarrionR, DodwellD J, RobertsonJ F, CalvoL, DowsettM, ClackG

Greater suppression of oestradiol

Anastrozole was found to provide more consistent and significantly more effective suppression of oestradiol compared with formestane.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

3.

Influence of letrozole and anastrozole on total body aromatization and plasma estrogen levels in postmenopausal breast cancer patients evaluated in a randomized, cross-over study.

Author: GeislerJürgen, HaynesBen, AnkerGun, DowsettMitch, LønningPer Eystein

Suppressed aromatase
Suppressed estrogen levels
None mentioned

Letrozole is a more potent suppressor of total-body aromatization and plasma estrogen levels than anastrozole in postmenopausal women with metastatic breast cancer. Letrozole 2.5 mg once daily resulted in a greater reduction in plasma levels of estrone, estradiol, and estrone sulfate than anastrozole 1 mg once daily.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

4.

Anastrozole alone or in combination with tamoxifen versus tamoxifen alone for adjuvant treatment of postmenopausal women with early breast cancer: first results of the ATAC randomised trial.

Author: BaumM, BudzarA U, CuzickJ, ForbesJ, HoughtonJ H, KlijnJ G M, SahmoudT,

Breast cancer treatment
Endometrial cancer
Thromboembolic disorders

Tamoxifen is an established treatment for postmenopausal women with hormone-sensitive breast cancer. This study aims to compare the safety and efficacy of tamoxifen with anastrozole alone and in combination.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

5.

Effect of neoadjuvant treatment with anastrozole on tumour histology in postmenopausal women with large operable breast cancer.

Author: AndersonT J, DixonJ M, StuartM, SahmoudT, MillerW R

Tumor shrinkage
Inconsistent effects

Anastrozole, a non-steroidal aromatase inhibitor, has been shown to be effective as neoadjuvant treatment for breast cancer. This study evaluated the histological changes in breast tumors after neoadjuvant anastrozole treatment. The study found that anastrozole treatment had marked effects on tumor histopathology, but these did not always correlate with clinical response.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

6.

Neoadjuvant treatment of postmenopausal breast cancer with anastrozole, tamoxifen, or both in combination: the Immediate Preoperative Anastrozole, Tamoxifen, or Combined with Tamoxifen (IMPACT) multicenter double-blind randomized trial.

Author: SmithIan E, DowsettMitch, EbbsStephen R, DixonJ Michael, SkeneAnthony, BlohmerJ-U, AshleySusan E, FrancisStephen, BoeddinghausIrene, WalshGeraldine,

Breast cancer treatment

This study aims to predict the outcome of an adjuvant therapy trial (ATAC) by comparing the effects of neoadjuvant tamoxifen, anastrozole, and a combination of both on postmenopausal women with breast cancer.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Clinical Trial, Phase IIIA Phase III trial is a trial that further rigorously verifies the efficacy and safety of a new drug or treatment, whose efficacy and safety have been confirmed in a Phase II trial, in a large number of patients, and evaluates whether it is superior to existing treatments.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

7.

Comparative effects of anastrozole, tamoxifen alone and in combination on plasma lipids and bone-derived resorption during neoadjuvant therapy in the impact trial.

Author: BanerjeeS, SmithI E, FolkerdL, IqbalJ, BarkerP, DowsettM,

Bone preservation
Improved lipid profile
Increased bone resorption

Anastrozole did not have a detrimental effect on lipid profiles following 3 months of therapy. There was a significant increase in CTx with anastrozole in contrast to tamoxifen.

Clinical Trial, Phase IIIA Phase III trial is a trial that further rigorously verifies the efficacy and safety of a new drug or treatment, whose efficacy and safety have been confirmed in a Phase II trial, in a large number of patients, and evaluates whether it is superior to existing treatments.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

8.

The ATAC ('Arimidex', Tamoxifen, Alone or in Combination) adjuvant breast cancer trial: first results of the endometrial sub-protocol following 2 years of treatment.

Author: DuffyS, JacksonT L, LansdownM, PhilipsK, WellsM, PollardS, ClackG, CoibionM, BiancoA R

Endometrial cancer risk reduction

Anastrozole, a third-generation aromatase inhibitor, may offer tolerability benefits in terms of effects on the endometrium compared to tamoxifen, which increases the risk of endometrial cancer.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

9.

Adjuvant endocrine therapy for postmenopausal women with early breast cancer.

Author: IngleJames N

Breast cancer treatment

This study examined the use of aromatase inhibitors in the treatment of postmenopausal women with hormone receptor-positive early breast cancer.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.

Language : English

10.

A prospective randomized trial comparing anastrozole and clomiphene citrate in an ovulation induction protocol using gonadotropins.

Author: SipeChristopher S, DavisWilliam A, MaifeldMichelle, Van VoorhisBradley J

Reduced hyperstimulation
Lower pregnancy rates

Anastrozole, when used in conjunction with gonadotropins, resulted in lower E(2) levels and fewer follicles than clomiphene citrate.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

11.

Aromatase inhibitors for treatment of advanced breast cancer in postmenopausal women.

Author: GibsonL J, DawsonC K, LawrenceD H, BlissJ M

Inhibit oestrogen synthesis
Treat breast cancer
Limited evidence on side effects

This review discusses hormonal treatments for advanced or metastatic breast cancer, including aromatase inhibitors (AIs). It highlights the development of AIs, including the third-generation AIs anastrozole, exemestane, and letrozole, and the limited randomized evidence on their response rates and side effects.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

12.

Molecular response to aromatase inhibitor treatment in primary breast cancer.

Author: MackayAlan, UrruticoecheaAnder, DixonJ Michael, DexterTim, FenwickKerry, AshworthAlan, DrurySuzanne, LarionovAlexey, YoungOliver, WhiteSharon, MillerWilliam R, EvansDean B, DowsettMitch

Effective estrogen suppression

Aromatase inhibitors, such as anastrozole and letrozole, effectively suppress estrogen synthesis in postmenopausal women. Their molecular effects on human breast carcinomas in vivo require further investigation.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

13.

Effect of anastrozole and tamoxifen as adjuvant treatment for early-stage breast cancer: 100-month analysis of the ATAC trial.

Author: , ForbesJohn F, CuzickJack, BuzdarAman, HowellAnthony, TobiasJeffrey S, BaumMichael

breast cancer treatment
long-term outcomes

This study examines the long-term outcomes of anastrozole compared with tamoxifen after a median follow-up of 100 months in a trial of adjuvant treatment for breast cancer.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

14.

Effect of anastrozole on bone mineral density: 5-year results from the anastrozole, tamoxifen, alone or in combination trial 18233230.

Author: EastellRichard, AdamsJudith E, ColemanRobert E, HowellAnthony, HannonRosemary A, CuzickJack, MackeyJohn R, BeckmannMatthias W, ClackGlen

Breast cancer treatment
Bone mineral density
Fracture risk

Anastrozole, a medication used to treat breast cancer, may lower bone density in women with breast cancer. While anastrozole is effective in treating breast cancer, it may increase the risk of fractures in women with low bone density.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

15.

Aromatase inhibitors for treatment of advanced breast cancer in postmenopausal women.

Author: GibsonLorna, LawrenceDavid, DawsonClaire, BlissJudith

Tumor regression
Limited trial evidence

This review examines the use of aromatase inhibitors (AIs) in the treatment of advanced breast cancer. While AIs have shown similar tumor-regressing effects to other endocrine treatments, the evidence regarding their response rates and side effects is still limited.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

16.

Randomized biomarker trial of anastrozole or low-dose tamoxifen or their combination in subjects with breast intraepithelial neoplasia.

Author: BonanniBernardo, SerranoDavide, GandiniSara, Guerrieri-GonzagaAliana, JohanssonHarriet, MacisDebora, CazzanigaMassimiliano, LuiniAlberto, CassanoEnrico, OldaniSabina, LienErnst A, PelosiGiuseppe, DecensiAndrea

Breast cancer treatment
Estrogenic effects
Pharmacokinetic interactions

The combination of anastrozole and tamoxifen is inferior to anastrozole alone in terms of disease-free survival. This may be due to an adverse pharmacokinetic interaction or a predominant estrogenic effect of tamoxifen under estrogen deprivation.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Clinical Trial, Phase IIA Phase II trial is a trial that further evaluates the efficacy and safety of a new drug or treatment, whose safety has been confirmed to some extent in a Phase I trial, in a small number of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

17.

Anastrozole and letrozole: an investigation and comparison of quality of life and tolerability.

Author: DixonJ Michael, RenshawLorna, LangridgeCarolyn, YoungOliver E, McHughMary, WilliamsLinda, MurrayJuliette, MacaskillE Jane, McCaigFiona, DixonOliver M, FallowfieldLesley J

Well tolerated

Anastrozole and letrozole are well-tolerated aromatase inhibitors with similar effects on quality of life.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

18.

Influence of comorbidities and age on risk of death without recurrence: a retrospective analysis of the Arimidex, Tamoxifen Alone or in Combination trial.

Author: RingAlistair, SestakIvana, BaumMichael, HowellAnthony, BuzdarAman, DowsettMitch, ForbesJohn F, CuzickJack

Improved breast cancer survival
Increased risk of death from other causes

This study examined the effects of comorbidities and age on treatment outcomes in postmenopausal women with early-stage breast cancer. The study found that comorbidities and age can affect the treatment received, breast cancer-related mortality, and competing causes of mortality.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

19.

Effects of adjuvant exemestane versus anastrozole on bone mineral density for women with early breast cancer (MA.27B): a companion analysis of a randomised controlled trial.

Author: GossPaul E, HershmanDawn L, CheungAngela M, IngleJames N, KhoslaSundeep, StearnsVered, ChalchalHaji, RowlandKendrith, MussHyman B, LindenHannah M, ScherJudite, PritchardKathleen I, ElliottCatherine R, Badovinac-CrnjevicTanja, St LouisJessica, ChapmanJudith-Anne W, ShepherdLois E

Breast cancer treatment
Bone damage

Exemestane, an aromatase inhibitor used for breast cancer treatment, may have a less detrimental effect on bone mineral density than anastrozole, another aromatase inhibitor. This suggests that exemestane, with its mild androgenic properties, may be a better option for bone health in breast cancer patients.

Clinical Trial, Phase IIIA Phase III trial is a trial that further rigorously verifies the efficacy and safety of a new drug or treatment, whose efficacy and safety have been confirmed in a Phase II trial, in a large number of patients, and evaluates whether it is superior to existing treatments.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

21.

Assessment and management of bone health in women with early breast cancer receiving endocrine treatment in the DATA study.

Author: van HellemondIrene E G, SmorenburgCarolien H, PeerPetronella G M, SwinkelsAstrid C P, SeynaeveCaroline M, van der SangenMaurice J C, KroepJudith R, de GraafHiltje, HonkoopAafke H, ErdkampFrans L G, van den BerkmortelFranchette W P J, de BoerMaaike, de RoosWilfred K, LinnSabine C, ImholzAlexander L T, Tjan-HeijnenVivianne C G,

Breast cancer treatment
Bone density loss

Extended anastrozole therapy (6 years) was not associated with a higher incidence of osteoporosis compared to shorter therapy (3 years). Anastrozole use was associated with a modest decrease in bone mineral density, partially reversible after anastrozole cessation.

Clinical Trial, Phase IIIA Phase III trial is a trial that further rigorously verifies the efficacy and safety of a new drug or treatment, whose efficacy and safety have been confirmed in a Phase II trial, in a large number of patients, and evaluates whether it is superior to existing treatments.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

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