High-dose fulvestrant led to modestly longer progression-free survival, suggesting that this agent might be appropriate earlier rather than later during the course of disease.
Multiple agents are available for treating women with endocrine-responsive metastatic breast cancer; agents such as tamoxifen and fulvestrant act by blocking estrogen receptors (ERs) on tumor cells, whereas aromatase inhibitors act by blocking the activity of extra-ovarian aromatase enzymes, thereby interfering with estrogen synthesis. Clinical decision making is based in part on which endocrine agent the patient might have received previously.
Fulvestrant is an estradiol analogue that binds ERs avidly. As a result, growth factor signaling is blocked, ER half-life is attenuated, and ER degradation is promoted. The FDA-approved dose (AD) and schedule of fulvestrant is 250 mg monthly as a single intramuscular injection. In this regimen, the ef…
Reviewing Author
DisclosuresConsultant/Advisory BoardLilly; AstraZeneca; Gilead
Grant/Research SupportBreast Cancer Research Foundation
Editorial BoardsClinical Breast Cancer; Oncology; Annals of Surgery; Breast Cancer Research and Treatment
Leadership Positions in Professional SocietiesNational Comprehensive Cancer Network (Chair, Breast Cancer Panel); American Board of Internal Medicine (Medical Oncology Board)
DisclosuresConsultant/Advisory BoardLilly; AstraZeneca; Gilead
Grant/Research SupportBreast Cancer Research Foundation
Editorial BoardsClinical Breast Cancer; Oncology; Annals of Surgery; Breast Cancer Research and Treatment
Leadership Positions in Professional SocietiesNational Comprehensive Cancer Network (Chair, Breast Cancer Panel); American Board of Internal Medicine (Medical Oncology Board)