Only four trials7,10,17,18 investigating the use of endocrine therapy in post-menopausal women specifically recruited patients with hormone receptor-positive disease. Hormone receptor status of participants was not explicitly stated in the Schmid (2001)14 publication. In all other trials, patients with unknown hormone receptor status were eligible to participate in the trials. Across all studies there was no consistent definition of ‘advanced breast cancer’.
The overall survival data from the included studies should be interpreted with caution due to the uncontrolled nature of treatment post-progression. In two post-menopausal trials patients crossed over to the alternate therapy on disease progression. In other trials, treatment following disease progression and study drug discontinuation was at the discretion of the investigator. Post-progression therapies may therefore have impacted on overall survival. Information about long-term results on overall survival and adverse events is not yet available.
Clinical practice recommendations developed by NBOCC* will be reviewed and revised as required as additional significant evidence becomes available.
* In February 2008, National Breast Cancer Centre (NBCC), incorporating the Ovarian Cancer Program, changed its name to National Breast and Ovarian Cancer Centre (NBOCC). In July 2011, NBOCC amalgamated with Cancer Australia to form a single national agency, Cancer Australia, to provide leadership in cancer control and improve outcomes for Australians affected by cancer.