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Breast Cancer Res Treat. 2009 Jan;113(1):145-51. doi: 10.1007/s10549-008-9915-6. Epub 2008 Feb 9.

Increase in response rate by prolonged treatment with neoadjuvant letrozole.

Author information

1
Edinburgh Breast Unit, Western General Hospital, Edinburgh EH4 2XU, Scotland. jmd@ed.ac.uk

Abstract

PURPOSE:

The aim of this study was to investigate the potential benefits of prolonged treatment with neoadjuvant letrozole.

PATIENTS AND METHODS:

About 182 consecutive patients have been treated in Edinburgh with neoadjuvant letrozole for 3 months or longer and 63 patients have continued on letrozole beyond 3 months. Outcomes are reported.

RESULTS:

Of the 63 patients who continued on letrozole, 38 patients took letrozole for more than 1 year and 23 took letrozole for more than 24 months. The median reduction in clinical volume in the first 3 months in these 63 patients was 52%. Similar reductions in median clinical volume were seen between three to 6 months (50%), 6-12 months and 12-24 months (medians 37 and 33%, respectively). At 3 months 69.8% of the 182 patients had a partial or complete response. The response rate increased to 83.5% with prolonged letrozole treatment. Continuing letrozole beyond 3 months increased the number of women who initially required mastectomy or had locally advanced breast cancer who were subsequently suitable for breast conserving surgery from 60% (81/134) at 3 months to 72% (96/134). Thirty-three women remain on letrozole alone (man age at diagnosis 83 years) and at 3 years the median time to treatment failure has not been reached.

CONCLUSION:

Continuing letrozole in responding patients beyond 3-4 months achieves further clinical reduction in tumour size. For elderly women with a short life expectancy letrozole alone may provide long-term disease control.

PMID:
18264759
DOI:
10.1007/s10549-008-9915-6
[Indexed for MEDLINE]

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