Tratamiento con fulvestrant en mujeres posmenopáusicas con cáncer de mama avanzado tras tratamiento hormonal previo / Fulvestrant in heavily pretreated postmenopausal women with advanced breast cancer

Fundamento y objetivo: Fulvestrant es un antiestrógeno puro que ha demostrado eficacia en cáncer de mama avanzado como tratamiento de segunda línea tras progresión a tamoxifeno. El objetivo del trabajo fue describir la experiencia clínica con fulvestrant y evaluar su eficacia y tolerabilidad. Material y método: 36 mujeres posmenopáusicas con cáncer de mama avanzado recibieron tratamiento con fulvestrant. El 62,8% de las pacientes recibió fulvestrant al menos en tercera línea. Resultados: El 91,4% había recibido tratamiento hormonal previo en la enfermedad avanzada y más del 50%, quimioterapia. La enfermedad metastásica fue visceral en un 5,7%, no visceral en un 54,3% y en ambas localizaciones en un 40%. Se obtuvo un 11,4% de respuestas parciales (RP), un 22,9% presentó estabilidad de la enfermedad (EE), alcanzando beneficio clínico (BC) el 31,4% de las pacientes. La mediana de tiempo a la progresión (TTP) fue de 4,18 meses (intervalo de confianza del 95% [IC] del 95%, 2,6–5,7 meses), mientras que la mediana de supervivencia global (SG) no se ha alcanzado, con una mediana de seguimiento de 8,9 meses. Se produjeron eventos adversos de grado I–II en un 22,9% de las pacientes. Conclusiones: Fulvestrant es un fármaco bien tolerado, que representa una eficaz opción de tratamiento hormonal en el cáncer de mama avanzado intensamente tratado con hormonoterapia y quimioterapia (AU)

Background and objective: Fulvestrant (Flv) is a pure antiestrogen without agonist activity. Flv is effective as second line treatment in postmenopausal women with advanced breast cancer after tamoxifen. Material and method: We performed a retrospective study of 36 consecutive postmenopausal women treated with Flv and advanced breast cancer progressing on prior therapies. 62,8% received Flv as third line treatment or more (all patients had previously received endocrine treatment for early or advanced breast cancer), 54,3% adjuvant chemotherapy and 67,5% received chemotherapy for metastatic disease. Our objective was to analyze the response rate, clinical benefit, time to progression (TTP) and toxicity profile. Results: In our study 11,4% patients had partial responses (PR) and 22,9% had a stable disease (SD) >24 weeks. Clinical benefit rate (CB) [RP+RC+SD]: 31,4%. TTP: 4,2 months (CI 95%, 2,6–5,8), with a median follow-up of 8,9 months. Flv was well tolerated, 22,9% patients had adverse events, all grade I/II, and only 5,7% of women gave up the treatment. Conclusions: These data demonstrate that Flv is an effective and safe therapy for heavily pre-treated postmenopausal women with advanced breast cancer (AU)

[Fulvestrant in heavily pretreated postmenopausal women with advanced breast cancer]. / Tratamiento con fulvestrant en mujeres posmenopáusicas con cáncer de mama avanzado tras tratamiento hormonal previo.

BACKGROUND AND OBJECTIVE: Fulvestrant (Flv) is a pure antiestrogen without agonist activity. Flv is effective as second line treatment in postmenopausal women with advanced breast cancer after tamoxifen. MATERIAL AND METHOD: We performed a retrospective study of 36 consecutive postmenopausal women treated with Flv and advanced breast cancer progressing on prior therapies. 62,8% received Flv as third line treatment or more (all patients had previously received endocrine treatment for early or advanced breast cancer), 54,3% adjuvant chemotherapy and 67,5% received chemotherapy for metastatic disease. Our objective was to analyze the response rate, clinical benefit, time to progression (TTP) and toxicity profile. RESULTS: In our study 11,4% patients had partial responses (PR) and 22,9% had a stable disease (SD) >24 weeks. Clinical benefit rate (CB) [RP+RC+SD]: 31,4%. TTP: 4,2 months (CI 95%, 2,6-5,8), with a median follow-up of 8,9 months. Flv was well tolerated, 22,9% patients had adverse events, all grade I/II, and only 5,7% of women gave up the treatment. CONCLUSIONS: These data demonstrate that Flv is an effective and safe therapy for heavily pre-treated postmenopausal women with advanced breast cancer.