Endocrine Cocktails for Advanced Breast Cancer

Prior studies have provided little evidence that combination endocrine therapy — for example, with tamoxifen plus older-generation aromatase inhibitors such as aminoglutethimide — improves outcomes over more common sequential endocrine therapy for patients with metastatic, hormone receptor–positive breast cancer. However, with the introduction of more-selective aromatase inhibitors (anastrozole, letrozole, and exemestane) and the novel estrogen-receptor agonist fulvestrant, the concept of combination endocrine therapy has been revisited.

Investigators have now compared the efficacy of single-agent therapy with anastrozole (1 mg/day) versus combination therapy with anastrozole and intramuscular fulvestrant (500 mg on day 1, 250 mg on days 14 …