Aromatase Inhibitors in Breast Cancer Treatment
Fitted Weibull survival distributions as described above were used to populate the partitioned survival models. Breast cancer is the most common cancer in women worldwide and the second most common cancer among women in the United States (1, 2). The American Cancer Society projects that 276,000 new cases will be diagnosed, and about 42,000 women will die from breast cancer in 2020 (3).
- It is unlikely that the Part D program ameliorated existing socioeconomic disparities in survival among breast cancer patients, but the availability of generic agents may do so.
- Estrogens are known to be important in the growth of breast cancers in both pre and postmenopausal women.
- Zhang et al.44 conducted a comparative study between the U.S. and China, specifically evaluating palbociclib plus fulvestrant versus fulvestrant alone.
- When the local recurrences are compared between starting with AI vs tamoxifen, we see there is a significant decrease in recurrences (30%) during the first year of therapy when switch is started with AI and not subsequently.
- Standard treatment for premenopausal women with hormone receptor-positive breast cancer is tamoxifen for 5-10 years, with or without ovarian suppression.
The base-case model assumed that AEs occurred during the first https://www.europe-state.eu/2025/01/30/omnadren-250-mg-jelfa-a-comprehensive-overview/ four weeks of initiating the therapies. All costs were standardized to 2019 U.S. dollars using the Consumer Price Index’s medical component and discounted by 3% annually (36). The model cohort characteristics were based on the patients enrolled in the MONALEESA-7 clinical trial (13, 20).
Side effects of ovarian suppression combined with tamoxifen or an aromatase inhibitor
The high incidence and prevalence of BC impose a tremendous financial burden and carry huge socioeconomic, emotional, and public health implications. Policymakers need robust evidence on the cost-effectiveness of different treatment options to base decisions on how best to use scarce healthcare resources. Learn more about risk-reducing drugs for women at high risk of breast cancer. Before you begin taking an aromatase inhibitor, talk with your health care team about possible side effects and how to manage them. Possible side effects of aromatase inhibitors include muscle pain, joint pain and menopausal symptoms (such as hot flashes).
Model Validation
The number of QALYs lived per patient among those receiving tamoxifen, AI, and switch therapy were 13.11 (12.20–14.00), 13.41 (12.43–14.28) and 13.32 (12.35–14.18), respectively. The incremental health benefits of AI, compared with tamoxifen and switch therapy, were 0.301 and 0.096 QALYs, respectively (Table 3). A side effect of aromatase inhibitors and goserelin is bone thinning (osteoporosis) or weakening. If you are starting treatment with an aromatase inhibitor you might have a DEXA scan first.
Cost-effectiveness acceptability curves were plotted based on the probabilistic sensitivity analysis. Cyclin-dependent kinase (CDK) 4/6 inhibitors in combination with endocrine therapy have been approved by the US Food and Drug Administration (FDA) for both first-line and second-line treatment of HR+/HER2- advanced or metastatic breast cancer (6–17). The incremental cost-effectiveness plane comparing the three adjuvant hormone therapies shows that both AI and switch treatment arms are more effective and less costly when compared to tamoxifen.
Approximately 90% of breast cancers in men are ER positive and approximately 80% are PR positive (3). If your ovaries are still functioning, aromatase inhibitors will have no effect. Within each intervention type, we summarized the specific intervention subtypes, specific interventions studied, outcomes assessed, and main results.