Effects of switching from anastrozole to letrozole, due to reimbursement policy, on the outcome of breast cancer therapy

Potchavit Aphinives, Damnern Vachirodom, Chaiyut Thanapaisal, Dhanes Rangsrikajee, Ongart Somintara Department of Surgery, Faculty of Medicine, Khon Kaen University, Thailand Background: Endocrine therapy is one of the standard treatments for estrogen-receptor-positive breast cancer patients. Letr...

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Autores principales:	Aphinives P, Vachirodom D, Thanapaisal C, Rangsrikajee D, Somintara O
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2014
Materias:	Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/b8cfaf23015c4814a7c692cd38ae5aa8
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spelling	oai:doaj.org-article:b8cfaf23015c4814a7c692cd38ae5aa82021-12-02T02:05:37ZEffects of switching from anastrozole to letrozole, due to reimbursement policy, on the outcome of breast cancer therapy1179-1314https://doaj.org/article/b8cfaf23015c4814a7c692cd38ae5aa82014-08-01T00:00:00Zhttp://www.dovepress.com/effects-of-switching-from-anastrozole-to-letrozole-due-to-reimbursemen-peer-reviewed-article-BCTThttps://doaj.org/toc/1179-1314 Potchavit Aphinives, Damnern Vachirodom, Chaiyut Thanapaisal, Dhanes Rangsrikajee, Ongart Somintara Department of Surgery, Faculty of Medicine, Khon Kaen University, Thailand Background: Endocrine therapy is one of the standard treatments for estrogen-receptor-positive breast cancer patients. Letrozole is the only aromatase inhibitor (AI) included in Thailand's essential drug list since the change of reimbursement policy in 2008, when patients had to change their AIs (other than letrozole) to letrozole. This study aimed to prove that the efficacy of anastrozole plus letrozole is not less than anastrozole alone. Methods: All medical records of breast cancer patients taking anastrozole between 2004 and 2013 were reviewed. Some patients were initially treated with anastrozole and then changed to letrozole (A-LTZ group), whereas the other patients were continuously treated with anastrozole until completion of therapy (ANZ group). Results: In a total of 180 (55.9%) out of the 322 cases, anastrozole was replaced with letrozole. The mean age of patients in the ANZ group was 54.9 years and that of those in the A-LTZ group was 54.2 years. Clinical stages (1–4) of the ANZ versus A-LTZ patients were four versus four, 76 versus 116, 46 versus 46, and 16 versus 14, respectively. ANZ patients took AI monotherapy (46.5%) and switching strategy (53.5%), while A-LTZ patients took AI monotherapy (53.9%) and switching strategy (46.1%). The overall survival (OS) of A-LTZ patients was longer than that of ANZ patients. Stage 2 and 4 patients in the A-LTZ group also had better OS than those in the ANZ group, but stage 3 patients had similar OS in both groups. Conclusion: Anastrozole can be replaced by letrozole any time during endocrine therapy. The patients taking anastrozole plus letrozole surprisingly seemed to have better OS than patients taking anastrozole alone. Keywords: estrogen-receptor-positive, hormonal-responsive, tamoxifen, reimbursement policy, essential drug listAphinives PVachirodom DThanapaisal CRangsrikajee DSomintara ODove Medical PressarticleNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENBreast Cancer: Targets and Therapy, Vol 2014, Iss default, Pp 145-150 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Aphinives P Vachirodom D Thanapaisal C Rangsrikajee D Somintara O Effects of switching from anastrozole to letrozole, due to reimbursement policy, on the outcome of breast cancer therapy
description	Potchavit Aphinives, Damnern Vachirodom, Chaiyut Thanapaisal, Dhanes Rangsrikajee, Ongart Somintara Department of Surgery, Faculty of Medicine, Khon Kaen University, Thailand Background: Endocrine therapy is one of the standard treatments for estrogen-receptor-positive breast cancer patients. Letrozole is the only aromatase inhibitor (AI) included in Thailand's essential drug list since the change of reimbursement policy in 2008, when patients had to change their AIs (other than letrozole) to letrozole. This study aimed to prove that the efficacy of anastrozole plus letrozole is not less than anastrozole alone. Methods: All medical records of breast cancer patients taking anastrozole between 2004 and 2013 were reviewed. Some patients were initially treated with anastrozole and then changed to letrozole (A-LTZ group), whereas the other patients were continuously treated with anastrozole until completion of therapy (ANZ group). Results: In a total of 180 (55.9%) out of the 322 cases, anastrozole was replaced with letrozole. The mean age of patients in the ANZ group was 54.9 years and that of those in the A-LTZ group was 54.2 years. Clinical stages (1–4) of the ANZ versus A-LTZ patients were four versus four, 76 versus 116, 46 versus 46, and 16 versus 14, respectively. ANZ patients took AI monotherapy (46.5%) and switching strategy (53.5%), while A-LTZ patients took AI monotherapy (53.9%) and switching strategy (46.1%). The overall survival (OS) of A-LTZ patients was longer than that of ANZ patients. Stage 2 and 4 patients in the A-LTZ group also had better OS than those in the ANZ group, but stage 3 patients had similar OS in both groups. Conclusion: Anastrozole can be replaced by letrozole any time during endocrine therapy. The patients taking anastrozole plus letrozole surprisingly seemed to have better OS than patients taking anastrozole alone. Keywords: estrogen-receptor-positive, hormonal-responsive, tamoxifen, reimbursement policy, essential drug list
format	article
author	Aphinives P Vachirodom D Thanapaisal C Rangsrikajee D Somintara O
author_facet	Aphinives P Vachirodom D Thanapaisal C Rangsrikajee D Somintara O
author_sort	Aphinives P
title	Effects of switching from anastrozole to letrozole, due to reimbursement policy, on the outcome of breast cancer therapy
title_short	Effects of switching from anastrozole to letrozole, due to reimbursement policy, on the outcome of breast cancer therapy
title_full	Effects of switching from anastrozole to letrozole, due to reimbursement policy, on the outcome of breast cancer therapy
title_fullStr	Effects of switching from anastrozole to letrozole, due to reimbursement policy, on the outcome of breast cancer therapy
title_full_unstemmed	Effects of switching from anastrozole to letrozole, due to reimbursement policy, on the outcome of breast cancer therapy
title_sort	effects of switching from anastrozole to letrozole, due to reimbursement policy, on the outcome of breast cancer therapy
publisher	Dove Medical Press
publishDate	2014
url	https://doaj.org/article/b8cfaf23015c4814a7c692cd38ae5aa8
work_keys_str_mv	AT aphinivesp effectsofswitchingfromanastrozoletoletrozoleduetoreimbursementpolicyontheoutcomeofbreastcancertherapy AT vachirodomd effectsofswitchingfromanastrozoletoletrozoleduetoreimbursementpolicyontheoutcomeofbreastcancertherapy AT thanapaisalc effectsofswitchingfromanastrozoletoletrozoleduetoreimbursementpolicyontheoutcomeofbreastcancertherapy AT rangsrikajeed effectsofswitchingfromanastrozoletoletrozoleduetoreimbursementpolicyontheoutcomeofbreastcancertherapy AT somintarao effectsofswitchingfromanastrozoletoletrozoleduetoreimbursementpolicyontheoutcomeofbreastcancertherapy
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Effects of switching from anastrozole to letrozole, due to reimbursement policy, on the outcome of breast cancer therapy

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