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Anastrozole

Class: Antiestrogens
VA Class: AN900
Chemical Name: α,α,α′,α′-Tetramethyl-5-(1H-1,2,4-triazol-1-ylmethyl)-1,3-benzenediacetonitrile
Molecular Formula: C17H19N5
CAS Number: 120511-73-1
Brands: Arimidex

Medically reviewed on Oct 16, 2017

Introduction

See also: Kisqali

Antineoplastic agent; selective aromatase inhibitor (type II).1 16

Uses for Anastrozole

Breast Cancer

Initial (primary) adjuvant therapy in postmenopausal women with early-stage hormone receptor-positive breast cancer.1 20 61

Sequential adjuvant therapy† following 2–3 years of adjuvant tamoxifen for early-stage hormone receptor-positive breast cancer in postmenopausal women.20

Extended adjuvant therapy† following 5 years of adjuvant tamoxifen for early-stage hormone receptor-positive breast cancer in postmenopausal women.54

Aromatase inhibitors are a treatment of choice for adjuvant hormonal therapy to lower risk of breast cancer recurrence in postmenopausal women with early-stage hormone receptor-positive breast cancer.20 61 An aromatase inhibitor-containing regimen is modestly more effective than tamoxifen alone.20 61

ASCO states that most postmenopausal women with early-stage hormone receptor-positive breast cancer should consider receiving an aromatase inhibitor during the course of adjuvant therapy, either as primary (initial) therapy or following 2–3 years of tamoxifen (sequential therapy), for a total of 5 years of adjuvant endocrine therapy.61 Data also support switching to an aromatase inhibitor following 5 years of adjuvant tamoxifen (extended adjuvant therapy).61 ASCO states that women who receive extended adjuvant therapy should receive tamoxifen for 5 years followed by an aromatase inhibitor for 3–5 years.61

Consider adverse effects, patient preference, and preexisting conditions when selecting an adjuvant regimen.61 Joint disorders (arthritis, arthrosis, arthralgia), fractures, and elevated cholesterol reported more frequently in patients receiving adjuvant anastrozole,1 whereas adverse gynecologic effects (endometrial cancer, vaginal discharge, vaginal bleeding), hot flushes, ischemic cerebrovascular events, and venous thromboembolism reported more frequently in those receiving adjuvant tamoxifen.1 50

First-line therapy for hormone receptor-positive (i.e., estrogen receptor-positive, progesterone receptor-positive, or both) or hormone receptor-unknown locally advanced or metastatic breast cancer in postmenopausal women.1 15 20

Second-line therapy for advanced breast cancer in postmenopausal women with disease progression following tamoxifen therapy.1 20 Usually ineffective in patients with estrogen receptor-negative breast cancer and those who fail tamoxifen therapy.1

Has been used for reduction in the incidence of breast cancer† in women at high risk for developing the disease.44

Anastrozole Dosage and Administration

General

  • Administration of corticosteroid replacement therapy not necessary.1 14 (See Actions.)

Administration

Oral Administration

Administer orally once daily without regard to meals.1

Dosage

Adults

Breast Cancer
Adjuvant Treatment of Early-stage Breast Cancer
Oral

1 mg once daily.1

Initial adjuvant therapy: Optimum duration unknown; duration of therapy in clinical study was 5 years.1 In patients who discontinue aromatase inhibitor therapy prior to 5 years, ASCO recommends consideration of tamoxifen to complete the 5-year adjuvant regimen.61

Sequential adjuvant therapy†: Optimal time to switch from tamoxifen to aromatase inhibitor therapy is unknown.61 ASCO states that disease-free patients may switch to an aromatase inhibitor after 2–3 years of adjuvant tamoxifen therapy to complete a 5-year sequential adjuvant regimen.61

Extended adjuvant therapy†: ASCO recommends that patients who receive an extended adjuvant regimen receive an aromatase inhibitor (e.g., anastrozole) for 3–5 years beyond the initial 5 years of tamoxifen therapy, to complete a total of 8–10 years of adjuvant endocrine therapy.61

First-line Treatment of Advanced Breast Cancer
Oral

1 mg once daily.1 Continue therapy until tumor progresses.1

Second-line Treatment of Advanced Breast Cancer
Oral

1 mg once daily.1 Continue therapy until tumor progresses.1

Prescribing Limits

Adults

Breast Cancer
Adjuvant Treatment of Early-stage Breast Cancer
Oral

Maximum 5 years of aromatase inhibitor therapy; toxicity beyond 5 years not established.61

Special Populations

Hepatic Impairment

Dosage adjustment not required in patients with mild to moderate hepatic impairment or stable hepatic cirrhosis.1 (See Special Populations under Pharmacokinetics.)

Not studied in patients with severe hepatic impairment.1

Renal Impairment

Dosage adjustment not required.1 (See Special Populations under Pharmacokinetics.)

Geriatric Patients

Dosage adjustment not required.1 (See Special Populations under Pharmacokinetics.)

Cautions for Anastrozole

Contraindications

  • Known hypersensitivity to anastrozole or any ingredient in the formulation.1

  • Premenopausal women.1 (See Premenopausal Women under Cautions.)

  • Pregnancy.1 (See Fetal/Neonatal Morbidity and Mortality under Cautions.)

Warnings/Precautions

Ischemic Cardiovascular Effects

Increased incidence of ischemic cardiovascular events (e.g., angina pectoris) reported in patients with preexisting ischemic heart disease; consider risks and benefits of therapy in these patients.1

Effects on Bone

Postmenopausal women receiving an aromatase inhibitor as adjuvant therapy are at high risk for osteoporosis.36

Bone mineral density (BMD) at lumbar spine and hip decreased in patients receiving anastrozole and increased in those receiving tamoxifen as initial (primary) adjuvant therapy.1 43 48 Incidence of fractures was higher with anastrozole versus tamoxifen during treatment, but not following completion of treatment.1 66

Evaluate all postmenopausal women initiating adjuvant aromatase inhibitor therapy for risk of osteoporotic fractures;70 71 73 determine BMD and assess other risk factors for fracture (e.g., age, low body mass index, family history of hip fracture, prior fragility fracture, history of cigarette smoking, excessive alcohol consumption, current or prior corticosteroid use).70 71 73 Closely monitor patients for changes in risk status during therapy, and assess BMD at regular intervals (e.g., every 1–2 years in those with osteopenia or osteoporosis).70 71 73 Consider other potential causes of osteoporosis (e.g., vitamin D deficiency, hyperthyroidism, hyperparathyroidism, hypercalciuria).70 71 73

Initiate appropriate therapy to prevent bone loss as clinically indicated.71 Base decision to initiate antiresorptive therapy (e.g., bisphosphonate, denosumab) on overall risk of fracture and rate of bone loss.70 71 72 73

Lifestyle changes (e.g., weight-bearing exercise, abstinence from smoking, moderation in alcohol consumption) and supplemental calcium and vitamin D recommended in all women receiving adjuvant anastrozole therapy.36 46 47 70 71 72 73

Lipid Effects

Increases in total serum cholesterol reported during therapy;1 consider monitoring serum cholesterol.1 46

Fetal/Neonatal Morbidity and Mortality

May cause fetal harm; embryotoxic and fetotoxic in animals.1 Contraindicated in women who are or may become pregnant (i.e., premenopausal women).1 If inadvertently used during pregnancy or patient becomes pregnant, apprise of potential fetal hazard.1

Sensitivity Reactions

Serious hypersensitivity reactions (e.g., anaphylaxis, angioedema, urticaria) reported rarely.1 48

Specific Populations

Pregnancy

Category X.1 (See Fetal/Neonatal Morbidity and Mortality under Cautions.)

Lactation

Not known whether anastrozole is distributed into milk; discontinue nursing or the drug.1

Pediatric Use

Has been used in clinical studies of adolescent boys 11–18 years of age with pubertal gynecomastia† and in girls 2 to <10 years of age with McCune-Albright syndrome and progressive precocious puberty†; however, efficacy not established for these indications.1

Geriatric Use

For adjuvant treatment of hormone receptor-positive early-stage breast cancer, efficacy (e.g., disease-free survival benefit) in women ≥65 years of age was less than efficacy observed in postmenopausal women <65 years of age.1

No substantial differences in efficacy for patients ≥65 years of age relative to younger adults when used as second line therapy for advanced breast cancer;1 moderately greater efficacy observed for patients ≥65 years of age when used as first-line therapy for locally advanced or metastatic breast cancer.1

Premenopausal Women

Clinical benefit not established in premenopausal women with breast cancer.1 Contraindicated in premenopausal women.1

Hepatic Impairment

Not studied in patients with severe hepatic impairment.1

Common Adverse Effects

Initial adjuvant therapy: Vasodilation, hot flushes (flashes), fatigue/asthenia, mood disturbance, pain, arthritis, arthralgia.1

Advanced-stage disease: GI disturbance (e.g., nausea), hot flushes, vasodilation, nausea, asthenia.1

Interactions for Anastrozole

Inhibits CYP1A2, 2C8/9, and 3A4 in vitro, but only at relatively high concentrations.1 Does not inhibit CYP2A6 or CYP2D6 in vitro.1 Pharmacokinetic interaction unlikely with drugs metabolized by CYP isoenzymes at recommended dosages.1

Specific Drugs

Drug

Interaction

Comment

Antipyrine

Pharmacokinetic interaction unlikely1

Estrogens

Antagonistic pharmacologic effects1

Concomitant use not recommended1

Raloxifene

Possible decreased plasma anastrozole concentrations36 37

Concomitant use not recommended36 37

Oral bisphosphonate (rather than raloxifene) is recommended if osteoporosis therapy is required36 37 46 47

Tamoxifen

Possible decreased plasma anastrozole concentrations;1 26 concomitant use does not improve efficacy1

Concomitant use not recommended1 36 37

Warfarin

No clinically important effects on anticoagulant activity or pharmacokinetics of warfarin1

Anastrozole Pharmacokinetics

Absorption

Bioavailability

Rapidly and well absorbed after oral administration, with peak plasma concentrations usually attained within 2 hours under fasting conditions.1

Steady-state plasma concentrations achieved in about 7 days.1

Onset

Serum estradiol concentrations reduced by approximately 70% within 24 hours of a 1-mg dose1 and by approximately 80% after 14 days of daily dosing.1

Duration

Suppression of serum estradiol concentrations maintained for up to 6 days after discontinuance of daily anastrozole administration.1

Food

Food reduces rate but does not affect extent of absorption.1

Distribution

Extent

Anastrozole crosses the placenta in animals;1 not known whether anastrozole crosses the placenta in humans.1

Not known whether anastrozole is distributed into milk.1

Plasma Protein Binding

40%.1

Elimination

Metabolism

Undergoes N-dealkylation, hydroxylation, and glucuronidation in the liver to multiple, pharmacologically inactive, metabolites.1

Elimination Route

Hepatic metabolism (85%) and renal excretion (10%).1

Half-life

Approximately 50 hours.1

Special Populations

No evidence of altered pharmacokinetics observed in women >80 years of age compared with women <50 years of age.1

Individuals with severe renal impairment (Clcr <30 mL/minute): Renal clearance decreased by approximately 50%, but total body clearance decreased by only 10%.1

Individuals with stable hepatic cirrhosis (related to alcohol abuse): Clearance reduced by approximately 30% compared with those with normal hepatic function;1 however, plasma concentrations within range compared with individuals with normal hepatic function.1

Stability

Storage

Oral

Tablets

20–25°C.1

Actions

  • Selectively inhibits conversion of androgens to estrogens.1 6 14

  • Decreased serum and tumor concentrations of estrogen inhibit breast tumor growth and delay disease progression.1 14 16

  • Does not affect synthesis of adrenal corticosteroid, aldosterone, or thyroid hormone.1 6 14

Advice to Patients

  • Importance of providing patient with a copy of the manufacturer’s patient information.1

  • Risk of osteoporosis.1 Life-style changes (e.g., weight-bearing exercise, abstinence from smoking, moderation of alcohol consumption) and dietary supplementation with calcium and vitamin D advised.36 46 47 Importance of BMD monitoring.1 71 73

  • Risk of fetal harm if used during pregnancy.1 Contraindicated in premenopausal women.1

  • Importance of informing clinicians of existing or contemplated concomitant therapy, including prescription (e.g., estrogens, raloxifene, tamoxifen), and OTC drugs, as well as any concomitant illnesses.1

  • Increased risk of ischemic cardiovascular events in patients with preexisting ischemic heart disease.1

  • Importance of immediately informing clinician if manifestations of a serious allergic reaction (e.g., swelling of face, lips, tongue, and/or throat; difficulty in swallowing and/or breathing) occur.1

  • Risk of hypercholesterolemia.1 Importance of lipoprotein monitoring.1 46

  • Importance of informing patients of other important precautionary information.1 (See Cautions.)

Preparations

Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details.

Please refer to the ASHP Drug Shortages Resource Center for information on shortages of one or more of these preparations.

* available from one or more manufacturer, distributor, and/or repackager by generic (nonproprietary) name

Anastrozole

Routes

Dosage Forms

Strengths

Brand Names

Manufacturer

Oral

Tablets, film-coated

1 mg*

Anastrozole Film-coated Tablets

Arimidex

AstraZeneca

AHFS DI Essentials. © Copyright 2018, Selected Revisions October 16, 2017. American Society of Health-System Pharmacists, Inc., 4500 East-West Highway, Suite 900, Bethesda, Maryland 20814.

† Use is not currently included in the labeling approved by the US Food and Drug Administration.

References

1. AstraZeneca. Arimidex (anastrozole) tablets prescribing information. Wilmington, DE; 2011 Apr.

2. Jonat W, Howell A, Blomqvist C et al for the Arimidex Study Group. A randomised trial comparing two doses of the new selective aromatase inhibitor anastrozole (Arimidex) with megestrol acetate in postmenopausal patients with advanced breast cancer. Eur J Cancer. 1996; 32A:404-12. http://www.ncbi.nlm.nih.gov/pubmed/8814682?dopt=AbstractPlus

3. Plourde PV, Dyroff M, Dukes M. Arimidex: a potent and selective fourth- generation aromatase inhibitor. Breast Cancer Res Treat. 1994; 30:103-11. http://www.ncbi.nlm.nih.gov/pubmed/7949201?dopt=AbstractPlus

4. Plourde PV, Dyroff M, Dowsett M et al. Arimidex: a new oral, once-a-day aromatase inhibitor. J Steroid Biochem Mol Biol. 1995; 53:175-9. http://www.ncbi.nlm.nih.gov/pubmed/7626450?dopt=AbstractPlus

5. Brodie AMH. Aromatase inhibitors in the treatment of breast cancer. J Steroid Biochem Mol Biol. 1994; 49:281-7. http://www.ncbi.nlm.nih.gov/pubmed/8043490?dopt=AbstractPlus

6. Yates RA, Dowsett M, Fisher GV et al. Arimidex (ZD1033): a selective, potent inhibitor of aromatase in post-menopausal female volunteers. Br J Cancer. 1996; 73:543- 8. http://www.ncbi.nlm.nih.gov/pubmed/8595172?dopt=AbstractPlus http://www.pubmedcentral.nih.gov/picrender.fcgi?tool=pmcentrez&artid=2074469&blobtype=pdf

7. Goss PE, Gwyn KMEH. Current perspectives on aromatase inhibitors in breast cancer. J Clin Oncol. 1994; 12:2460-70. http://www.ncbi.nlm.nih.gov/pubmed/7964964?dopt=AbstractPlus

8. Buzdar AU, Plourde PV, Jones SE et al and the N American Arimidex Study Group. Randomized phase III study of the new selective aromatase inhibitor arimidex (A) (ZD1033) versus megestrol acetate (MA) in the treatment of postmenopausal women with advanced breast cancer. Breast. 1995; 4:256-7.

9. Zeneca Pharmaceuticals. Arimidex (anastrozole) product monograph. Wilmington, DE; 1996 Mar.

10. Zeneca Pharmaceuticals. Arimidex (anastrozole) tablets product review. Wilmington, DE; 1996 Mar.

11. Baldinger SL, DeFusco P. Focus on anastrozole: an aromatase inhibitor for the treatment of hormonally dependent advanced breast cancer. Formulary. 1996; 31:363- 73.

12. Zeneca Pharmaceuticals, Wilmington, DE: Personal communication.

13. Harris JR, Morrow M, Bonadonna G. Cancer of the breast. In: DeVita VT Jr, Hellman S, Rosenberg SA, eds. Cancer: principles and practice of oncology. 4th ed. Philadelphia, PA: J.B. Lippincott; 1993:1264-332.

14. Higa GM, AlKhouri N. Anastrozole: a selective aromatase inhibitor for the treatment of breast cancer. Am J Health-Syst Pharm. 1998; 55:445-52. http://www.ncbi.nlm.nih.gov/pubmed/9522927?dopt=AbstractPlus

15. Anon. Drugs of choice for cancer. Treat Guidel Med Lett. 2003; 1:41-52. http://www.ncbi.nlm.nih.gov/pubmed/15529105?dopt=AbstractPlus

16. Ibrahim NK, Buzdar AU. Aromatase inhibitors: current status. Am J Clin Oncol. 1995; 18:407-17. http://www.ncbi.nlm.nih.gov/pubmed/7572758?dopt=AbstractPlus

17. Lonning PE. Aromatase inhibition for breast cancer treatment. Acta Oncol. 1996; 35(Suppl 5):38-43. http://www.ncbi.nlm.nih.gov/pubmed/9142963?dopt=AbstractPlus

18. Food and Drug Administration. Labeling and prescription drug advertising; content and format for labeling for human prescription drugs. 21 CFR Parts 201 and 202. Final Rule. [Docket No. 75N-0066] Fed Regist. 1979; 44:37434-67.

19. Department of Health and Human Services, Food and Drug Administration. Subpart B—Labeling requirements for prescription drugs and/or insulin. (21 CFR Ch. 1 (4-1-87 Ed.). 1987:18-24.

20. Breast cancer. From: PDQ. Physician data query (database). Bethesda, MD: National Cancer Institute; 2011 Nov 21.

21. Bonneterre J, Thurlimann B, Robertson JFR et al. Anastrozole versus tamoxifen as first-line therapy for advanced breast cancer in 668 postmenopausal women: results of the Tamoxifen or Arimidex Randomized Group Efficacy and Tolerability study. J Clin Oncol. 2000; 18:3748-57. http://www.ncbi.nlm.nih.gov/pubmed/11078487?dopt=AbstractPlus

22. Nabholtz JM, Buzdar A, Pollak M et al. Anastrozole is superior to tamoxifen as first-line therapy for advanced breast cancer in postmenopausal women: results of a North American multicenter randomized trial. J Clin Oncol. 2000; 18:3758-67. http://www.ncbi.nlm.nih.gov/pubmed/11078488?dopt=AbstractPlus

23. Buzdar AU, Jonat W, Howell A et al. Anastrozole versus megestrol acetate in the treatment of postmenopausal women with advanced breast carcinoma: results of a survival update based on a combined analysis of data from two mature phase III trials. Cancer. 1998; 83:1142-52. http://www.ncbi.nlm.nih.gov/pubmed/9740079?dopt=AbstractPlus

24. Baum M, Budzar AU, Cuzick J et al. Anastrozole alone or in combination with tamoxifen versus tamoxifen alone for adjuvant treatment of postmenopausal women with early breast cancer: first results of the ATAC randomised trial. Lancet. 2002; 359:2131-9. http://www.ncbi.nlm.nih.gov/pubmed/12090977?dopt=AbstractPlus

25. Winer EP, Hudis C, Burstein HJ et al. American Society of Clinical Oncology technology assessment on the use of aromatase inhibitors as adjuvant therapy for women with hormone receptor-positive breast cancer: status report 2002. J Clin Oncol. 2002; 20:3317-27. http://www.ncbi.nlm.nih.gov/pubmed/12149306?dopt=AbstractPlus

26. The ATAC Trialists’ Group. Pharmacokinetics of anastrozole and tamoxifen alone, and in combination, during adjuvant endocrine therapy for early breast cancer in postmenopausal women: a sub-protocol of the ‘ArimidexTM and Tamoxifen Alone or in Combination’ (ATAC) trial. Br J Cancer. 2001; 85:317-24. http://www.ncbi.nlm.nih.gov/pubmed/11487258?dopt=AbstractPlus http://www.pubmedcentral.nih.gov/picrender.fcgi?tool=pmcentrez&artid=2364083&blobtype=pdf

27. Baum M, Buzdar A, Cuzick J et al. Anastrozole alone or in combination with tamoxifen versus tamoxifen alone for adjuvant treatment of postmenopausal women with early-stage breast cancer: results of the ATAC (Arimidex, Tamoxifen Alone or in Combination) trial efficacy and safety update analyses. Cancer. 2003; 98:1802-10. http://www.ncbi.nlm.nih.gov/pubmed/14584060?dopt=AbstractPlus

28. Ravdin P. Aromatase inhibitors for the endocrine adjuvant treatment of breast cancer. Lancet. 2002; 359:2126-7. http://www.ncbi.nlm.nih.gov/pubmed/12090973?dopt=AbstractPlus

29. Stasi R, Terzoli E. Questions about anastrozole for early breast cancer. Lancet. 2002; 360:1890. http://www.ncbi.nlm.nih.gov/pubmed/12480404?dopt=AbstractPlus

30. Baum M. Questions about anastrozole for early breast cancer. Lancet. 2002; 360:1890-1.

31. Winer EP, Hudis C, Burstein HJ et al. American Society of Clinical Oncology technology assessment working group update: use of aromatase inhibitors in the adjuvant setting. J Clin Oncol. 2003; 21:2597-9. http://www.ncbi.nlm.nih.gov/pubmed/12732612?dopt=AbstractPlus

32. Cuzick J, Buzdar A, Baum M et al. Adjuvant use of anastrozole in breast cancer. J Clin Oncol. 2004; 22:1524-6. http://www.ncbi.nlm.nih.gov/pubmed/15084628?dopt=AbstractPlus

33. The ASCO Aromatase Inhibitors Technology Assessment Working Group. Adjuvant use of anastrozole in breast cancer: author reply. J Clin Oncol. 2004; 22:1526-7.

34. Fleming GF. Adjuvant aromatase inhibitors: are we there yet? Cancer. 2003; 98:1779-81.

35. Carraway H, Wolff AC. Anastrozole is safer and may be more effective than tamoxifen in postmenopausal women with early-stage breast cancer. Cancer Treat Rev. 2004; 30:303-7. http://www.ncbi.nlm.nih.gov/pubmed/15059653?dopt=AbstractPlus

36. Hilner BE, Ingle JN, Chelbowski RT et al. American Society of Clinical Oncology 2003 update on the role of bisphosphonates and bone health issues in women with breast cancer. J Clin Oncol. 2003; 21:4042-57. http://www.ncbi.nlm.nih.gov/pubmed/12963702?dopt=AbstractPlus

37. Wellington K, Faulds DM. Anastrozole: in early breast cancer. Drugs. 2002; 62:2483-90; discussion 2491-2. http://www.ncbi.nlm.nih.gov/pubmed/12421108?dopt=AbstractPlus

38. Food and Drug Administration. Center for Drug Evaluation and Research: Application number 20-541/S-006: Medical Reviews. From FDA web site. http://www.accessdata.fda.gov/drugsatfda_docs/nda/2000/20-541S006_Arimidex.cfm

39. Costa SD, Kaufmann M. Is anastrozole superior to tamoxifen as first-line therapy for advanced breast cancer? J Clin Oncol. 2001; 19:2580. Letter.

40. Bagley CM Jr, Rowbotham RK. Is anastrozole superior to tamoxifen as first-line therapy for advanced breast cancer? J Clin Oncol. 2001; 19:2578-9. Letter.

41. Gluck S. Anastrozole is superior to tamoxifen as first-line therapy in hormone receptor-positive advanced breast carcinoma. Cancer. 2002; 95:2442-3. http://www.ncbi.nlm.nih.gov/pubmed/12436453?dopt=AbstractPlus

42. Donnellan PP, Douglas SL, Cameron DA et al. Aromatase inhibitors and arthralgia. J Clin Oncol. 2001; 19:2767. http://www.ncbi.nlm.nih.gov/pubmed/11352973?dopt=AbstractPlus

43. Eastell R, Adams JE, Coleman RE et al. Effect of anastrozole on bone mineral density: 5-year results from the anastrozole, tamoxifen, alone or in combination trial 18233230. J Clin Oncol. 2008; 26:1051-8. http://www.ncbi.nlm.nih.gov/pubmed/18309940?dopt=AbstractPlus

44. Chlebowski RT, Col N, Winer EP et al. American Society of Clinical Oncology technology assessment of pharmacologic interventions for breast cancer risk reduction including tamoxifen, raloxifene, and aromatase inhibition. J Clin Oncol. 2002; 20:3328-43. http://www.ncbi.nlm.nih.gov/pubmed/12149307?dopt=AbstractPlus

45. Forward DP, Cheung KL, Jackson L et al. Clinical and endocrine data for goserelin plus anastrozole as second-line endocrine therapy for premenopausal advanced breast cancer. Br J Cancer. 2004; 90:590-4. http://www.ncbi.nlm.nih.gov/pubmed/14760369?dopt=AbstractPlus http://www.pubmedcentral.nih.gov/picrender.fcgi?tool=pmcentrez&artid=2409605&blobtype=pdf

46. Reviewers’ comments (personal observations).

47. AstraZeneca. Wilmington, DE: Personal communication.

48. Food and Drug Administration. MedWatch—Safety-related drug labeling changes: Arimidex (anastrozole tablets) [Aug 2004]. From FDA web site. http://www.accessdata.fda.gov/drugsatfda_docs/appletter/2004/20541s015ltr.pdf

49. Winer EP, Hudis C, Burstein HJ et al. American Society of Clinical Oncology technology assessment on the use of aromatase inhibitors as adjuvant therapy for postmenopausal women with hormone receptor-positive breast cancer: status report 2004. J Clin Oncol. 2005; 23:619-29. http://www.ncbi.nlm.nih.gov/pubmed/15545664?dopt=AbstractPlus

50. Howell A, Cuzick J, Baum M et al. Results of the ATAC (Arimidex, Tamoxifen, Alone or in Combination) trial after completion of 5 years’ adjuvant treatment for breast cancer. Lancet. 2005; 365:60-2. http://www.ncbi.nlm.nih.gov/pubmed/15639680?dopt=AbstractPlus

51. Boccardo F, Rubagotti A, Puntoni M et al. Switching to anastrozole versus continued tamoxifen treatment of early breast cancer: preliminary results of the Italian Tamoxifen Anastrozole Trial. J Clin Oncol. 2005; 23:5138-47. http://www.ncbi.nlm.nih.gov/pubmed/16009955?dopt=AbstractPlus

52. Jakesz R, Jonat W, Gnant M et al. Switching of postmenopausal women with endocrine-responsive early breast cancer to anastrozole after 2 years’ adjuvant tamoxifen: combined results of ABCSG trial 8 and ARNO 95 trial. Lancet. 2005; 366:455-62. http://www.ncbi.nlm.nih.gov/pubmed/16084253?dopt=AbstractPlus

53. Jonat W, Gnant M, Boccardo F et al. Effectiveness of switching from adjuvant tamoxifen to anastrozole in postmenopausal women with hormone-sensitive early-stage breast cancer: a meta-analysis. Lancet Oncol. 2006; 7:991-6. http://www.ncbi.nlm.nih.gov/pubmed/17138220?dopt=AbstractPlus

54. Jakesz R, Greil R, Gnant M et al. Extended adjuvant therapy with anastrozole among postmenopausal breast cancer patients: results from the randomized Austrian Breast and Colorectal Cancer Study Group Trial 6a. J Natl Cancer Inst. 2007; 99:1845-53. http://www.ncbi.nlm.nih.gov/pubmed/18073378?dopt=AbstractPlus

55. Nabholtz JM, Bonneterre J, Buzdar A et al. Anastrozole (Arimidex) versus tamoxifen as first-line therapy for advanced breast cancer in postmenopausal women: survival analysis and updated safety results. Eur J Cancer. 2003; 39:1684-9. http://www.ncbi.nlm.nih.gov/pubmed/12888362?dopt=AbstractPlus

56. Mauri D, Pavlidis N, Polyzos NP et al. Survival with aromatase inhibitors and inactivators versus standard hormonal therapy in advanced breast cancer: meta-analysis. J Natl Cancer Inst. 2006; 98:1285-91. http://www.ncbi.nlm.nih.gov/pubmed/16985247?dopt=AbstractPlus

57. Fallowfield L, Cella D, Cuzick J et al. Quality of life of postmenopausal women in the Arimidex, Tamoxifen, Alone or in Combination (ATAC) Adjuvant Breast Cancer Trial. J Clin Oncol. 2004; 22:4261-71. http://www.ncbi.nlm.nih.gov/pubmed/15514369?dopt=AbstractPlus

58. Eisner A, Falardeau J, Toomey MD et al. Retinal hemorrhages in anastrozole users. Optom Vis Sci. 2008; 85:301-8. http://www.ncbi.nlm.nih.gov/pubmed/18451730?dopt=AbstractPlus

59. Partridge AH, LaFountain A, Mayer E et al. Adherence to initial adjuvant anastrozole therapy among women with early-stage breast cancer. J Clin Oncol. 2008; 26:556-62. http://www.ncbi.nlm.nih.gov/pubmed/18180462?dopt=AbstractPlus

60. Arimidex, Tamoxifen, Alone or in Combination (ATAC) Trialists’ Group, Forbes JF, Cuzick J et al. Effect of anastrozole and tamoxifen as adjuvant treatment for early-stage breast cancer: 100-month analysis of the ATAC trial. Lancet Oncol. 2008; 9:45-53.

61. Burstein HJ, Prestrud AA, Seidenfeld J et al. American Society of Clinical Oncology clinical practice guideline: update on adjuvant endocrine therapy for women with hormone receptor-positive breast cancer. J Clin Oncol. 2010; 28:3784-96. http://www.ncbi.nlm.nih.gov/pubmed/20625130?dopt=AbstractPlus http://www.pubmedcentral.nih.gov/picrender.fcgi?tool=pmcentrez&artid=5569672&blobtype=pdf

62. AstraZeneca. Arimidex (anastrozole) tablets prescribing information. Wilmington, DE; 2008 Aug.

63. Boccardo F, Rubagotti A, Guglielmini P et al. Switching to anastrozole versus continued tamoxifen treatment of early breast cancer. Updated results of the Italian tamoxifen anastrozole (ITA) trial. Ann Oncol. 2006; 17 Suppl 7:vii10-4. http://www.ncbi.nlm.nih.gov/pubmed/16760270?dopt=AbstractPlus

64. Dubsky PC, Jakesz R, Mlineritsch B et al. Tamoxifen and anastrozole as a sequencing strategy: a randomized controlled trial in postmenopausal patients with endocrine-responsive early breast cancer from the Austrian Breast and Colorectal Cancer Study Group. J Clin Oncol. 2012; 30:722-8. http://www.ncbi.nlm.nih.gov/pubmed/22271481?dopt=AbstractPlus

65. Kaufmann M, Jonat W, Hilfrich J et al. Improved overall survival in postmenopausal women with early breast cancer after anastrozole initiated after treatment with tamoxifen compared with continued tamoxifen: the ARNO 95 Study. J Clin Oncol. 2007; 25:2664-70. http://www.ncbi.nlm.nih.gov/pubmed/17563395?dopt=AbstractPlus

66. Cuzick J, Sestak I, Baum M et al. Effect of anastrozole and tamoxifen as adjuvant treatment for early-stage breast cancer: 10-year analysis of the ATAC trial. Lancet Oncol. 2010; 11:1135-41. http://www.ncbi.nlm.nih.gov/pubmed/21087898?dopt=AbstractPlus

67. Duffy S, Jackson TL, Lansdown M et al. The ATAC adjuvant breast-cancer trial: six-year results of the endometrial subprotocol. J Obstet Gynaecol. 2010; 30:596-604. http://www.ncbi.nlm.nih.gov/pubmed/20701510?dopt=AbstractPlus

68. Cella D, Fallowfield L, Barker P et al. Quality of life of postmenopausal women in the ATAC (“Arimidex”, tamoxifen, alone or in combination) trial after completion of 5 years' adjuvant treatment for early breast cancer. Breast Cancer Res Treat. 2006; 100:273-84. http://www.ncbi.nlm.nih.gov/pubmed/16944295?dopt=AbstractPlus

70. Hadji P, Aapro MS, Body JJ et al. Management of aromatase inhibitor-associated bone loss in postmenopausal women with breast cancer: practical guidance for prevention and treatment. Ann Oncol. 2011; 22:2546-55. http://www.ncbi.nlm.nih.gov/pubmed/21415233?dopt=AbstractPlus

71. Reid DM, Doughty J, Eastell R et al. Guidance for the management of breast cancer treatment-induced bone loss: a consensus position statement from a UK Expert Group. Cancer Treat Rev. 2008; 34 Suppl 1:S3-18. http://www.ncbi.nlm.nih.gov/pubmed/18515009?dopt=AbstractPlus

72. Aapro M, Abrahamsson PA, Body JJ et al. Guidance on the use of bisphosphonates in solid tumours: recommendations of an international expert panel. Ann Oncol. 2008; 19:420-32. http://www.ncbi.nlm.nih.gov/pubmed/17906299?dopt=AbstractPlus

73. Body JJ, Bergmann P, Boonen S et al. Management of cancer treatment-induced bone loss in early breast and prostate cancer -- a consensus paper of the Belgian Bone Club. Osteoporos Int. 2007; 18:1439-50. http://www.ncbi.nlm.nih.gov/pubmed/17690930?dopt=AbstractPlus

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