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- W2072471301 abstract "Background: The agonist effects of tamoxifen (TAM) may limit efficacy against some breast cancers but the extent to which these agonist effects occur is unknown. To address this issue, changes in estrogen-regulated gene expression were monitored during preoperative endocrine therapy with either TAM or the aromatase inhibitor letrozole (LET). Methods: Postmenopausal breast cancer patients received 4 months preoperative endocrine therapy with either LET or TAM in a double-blind phase III study. Biopsies were obtained pre and post treatment and assessed by immunohistochemistry (IHC) for expression of the estrogen-regulated proteins progesterone receptor (PgR, n = 223) and trefoil factor I (PS2, n = 219). Allred IHC scores were assigned and categorized as low (O-2), medium (3-5) and high (6-8). A change with treatment was recorded if the post treatment score changed category from pre treatment to cause an increase or decrease in expression category. Results: A decrease in PgR category was more frequent with LET (65% LET vs 23% TAM). An increase in PgR level was more frequent with TAM (29% TAM vs 5% LET). Similar data were obtained with PS2 (p = 0.001. logistic regression). Study outcomes were superior for LET when compared with TAM. For a subset of patients with study biopsy confirmed ER and/or PgR positivity clinical response rates (CR + PR) were 60% for LET vs 41% TAM. p = 0.004 (Mantel-Haenszel (M-H)) and breast conservation occurred in 48% of patients treated with LET vs 36% on TAM, p = 0.036 (M-H). Conclusion: Agonist effects on PgR and PS2 occur in about one third of cases treated with TAM and rarely with LET. LET was more effective in inducing regression of ER and/or PgR positive primary breast cancer than TAM." @default.
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- W2072471301 date "2001-09-01" @default.
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- W2072471301 title "Letrozole (femara) is a more effective inhibitor of estrogen activity than tamoxifen: Evidence from a randomized phase III trial of 4 months preoperative endocrine therapy for postmenopausal women with primary invasive breast cancer" @default.
- W2072471301 doi "https://doi.org/10.1016/s0959-8049(01)80054-x" @default.
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