Prolonged Adjuvant Aromatase Inhibitor Treatment for Early Breast Cancer

Outcomes were not superior with 5 versus 2.5 years of extended letrozole therapy.

The oncologic mantra “more is better” is not sustainable in an era when tailoring therapy to the clinical situation is fundamental. An exception to this dogma is trials showing a benefit of extending adjuvant tamoxifen beyond 5 years for women with early breast cancer (N Engl J Med 2016; 375:209). Nevertheless, a variety of studies have failed to show an advantage of prolonging adjuvant aromatase inhibitor (AI) therapy in this patient population. Moreover, trials of extended therapy have highlighted increasing nonadherence as well as declines in bone density and increased fracture rates.

Now, Dutch investigators have conducted a multicenter, randomized, open-label phase III trial (IDEAL) to determine the effect of prolonging AI therapy in 18…

Reviewing Author

William J. Gradishar, MD

Disclosures

Consultant/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)