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Meta-Analysis
. 2017 Jul 18;8(29):48362-48374.
doi: 10.18632/oncotarget.16466.

A meta-analysis of randomized controlled trials comparing the efficacy and safety of anastrozole versus tamoxifen for breast cancer

Yan Yang  1 , Wei Pan  2 , Xinyu Tang  1 , Shuqing Wu  3 , Xinchen Sun  1
Affiliations
Meta-Analysis

A meta-analysis of randomized controlled trials comparing the efficacy and safety of anastrozole versus tamoxifen for breast cancer

Yan Yang et al. Oncotarget. .

Abstract

Whether anastrozole has superior effects to tamoxifen for breast cancer remains controversial. Therefore, we conducted this meta-analysis of randomized controlled trials (RCTs) to compare the efficacy and safety of anastrozole versus tamoxifen as adjuvant therapy in breast cancer. A systematic literature search of PubMed, Web of Science, Embase, and Cochrane library were performed to evaluate the survival benefits and toxicity profiles of patients with breast cancer who were treated with anastrozole or tamoxifen. The main outcome measures included disease-free survival (DFS), recurrence-free survival (RFS), overall survival (OS), overall response rate (ORR), and adverse events. Hazard ratios (HRs) or risk ratios (RRs) with 95% confidence intervals (CIs) were pooled using a fixed-effects model or random-effects model. Nine RCTs with a total of 15,300 patients met the inclusion criteria and were included in this meta-analysis. Pooled estimates suggested that, anastrozole was associated with a significantly improvement in DFS (HR=0.72, 95%CI: 0.55-0.94; P=0.016), and ORR (RR=1.21, 95% CI: 1.05-1.39; P=0.009) than tamoxifen. But it did not prolong OS (HR=0.96, 95%CI: 0.77-1.21; P=0.751). Compared with tamoxifen, anastrozole induced a higher incidence of arthralgia (RR=1.55, 95%CI: 1.20-1.99; P=0.001) and bone pain (RR=1.31, 95%CI: 1.05-1.62; P=0.015), as well as a lower incidence of vaginal bleeding (RR=0.51, 95%CI: 0.28-0.93; P=0.029), vaginal discharge (RR=0.31, 95%CI: 0.12-0.82; P=0.017), and thromboembolic events (RR=0.39, 95%CI: 0.28-0.55; P<0.001). Based on the current evidence, patients with breast cancer would benefit from the anastrozole treatment.

Keywords: anastrozole; breast cancer; meta-analysis; tamoxifen.

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Conflict of interest statement

CONFLICTS OF INTEREST

All the authors declare that they have no conflict of interest.

Figures

Figure 1
Figure 1. Eligibility of studies for inclusion in meta-analysis
Figure 2
Figure 2. Risk of bias summary
Figure 3
Figure 3. Forest plot showing the effect of anastrozole versus tamoxifen on disease free survival
Figure 4
Figure 4. Forest plot showing the effect of anastrozole versus tamoxifen on recurrence free survival
Figure 5
Figure 5. Forest plot showing the effect of anastrozole versus tamoxifen on overall survival
Figure 6
Figure 6. Forest plot showing the effect of anastrozole versus tamoxifen on overall response rate
See this image and copyright information in PMC

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References

    1. Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D. Global cancer statistics. CA Cancer J Clin. 2011;61:69–90. doi: 10.3322/caac.20107. - DOI - PubMed
    1. Cuzick J, Sestak I, Forbes JF, Dowsett M, Knox J, Cawthorn S, Saunders C, Roche N, Mansel RE, von Minckwitz G, Bonanni B, Palva T, Howell A. Anastrozole for prevention of breast cancer in high-risk postmenopausal women (IBIS-II): an international, double-blind, randomised placebo-controlled trial. Lancet. 2014;383:1041–8. doi: 10.1016/s0140-6736(13)62292-8. - DOI - PubMed
    1. Worni M, Akushevich I, Greenup R, Sarma D, Ryser MD, Myers ER, Hwang ES. Trends in Treatment Patterns and Outcomes for Ductal Carcinoma In situ. J Natl Cancer Inst. 2015;107:djv263. doi: 10.1093/jnci/djv263. - DOI - PMC - PubMed
    1. Goodwin A, Parker S, Ghersi D, Wilcken N. Post-operative radiotherapy for ductal carcinoma in situ of the breast. Cochrane Database Syst Rev. 2013:Cd000563. doi: 10.1002/14651858.CD000563.pub7. - DOI - PMC - PubMed
    1. Dodwell D, Clements K, Lawrence G, Kearins O, Thomson CS, Dewar J, Bishop H. Radiotherapy following breast-conserving surgery for screen-detected ductal carcinoma in situ: indications and utilisation in the UK. Interim findings from the Sloane Project. Br J Cancer. 2007;97:725–9. doi: 10.1038/sj.bjc.6603945. - DOI - PMC - PubMed

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