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Giving patients a choice improves quality of life: A multi- centre, investigator-blind, randomised, crossover study comparing letrozole with anastrozole

Thomas, R; Godward, S; Makris, A; Bloomfield, D; Moody, AM; Williams, M; (2004) Giving patients a choice improves quality of life: A multi- centre, investigator-blind, randomised, crossover study comparing letrozole with anastrozole. Clinical Oncology , 16 (7) pp. 485-491.

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Abstract

Aims: Although the third-generation aromatase inhibitors are generally well tolerated, side-effects still occur in up to 40% of women. As more women are taking these drugs for longer, the issue as to which version is better tolerated is now a significant patient concern. This study aimed to assess whether tolerance for either letrozole or anastrozole can differ for each individual in terms of early quality of life (QoL), whether patients welcome being given a preference and whether this correlated with formal toxicity scoring. Materials and methods: A single-blind, crossover trial, with 72 women with breast cancer who had experienced tamoxifen failure. Randomised to either letrozole 2.5 mg or anastrozole 1 mg, for 4 weeks, 1 week off, then crossover for 4 weeks. Results: Patients were confidently able to choose which drug suited them best (letrozole 68%, anastrozole 32%; P < 0.01). Fewer patients, when taking letrozole, experienced adverse events than when taking anastrozole (43% vs 65%; P = 0.0028). QoL was better when patients were taking letrozole than when they took anastrozole (P = 0.02). Conclusions: As toxicity and QoL strongly correlated with patient preference for either drug, albeit with a tendency towards letrozole, this suggests that patient preference is now a legitimate and useful end point for future crossover studies. In routine practice, women would warmly welcome extra involvement in the decision-making process via a crossover manoeuvre if side-effects develop, whichever aromatase inhibitor is prescribed initially. (C) 2004 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved

Type: Article
Title: Giving patients a choice improves quality of life: A multi- centre, investigator-blind, randomised, crossover study comparing letrozole with anastrozole
Additional information: WoS ID: 000224148600010 JournalEnglishArticle26ELSEVIER SCIENCE LONDONBAUM M, 2001, BREAST CANCER RES TR, V69, P210; BAUM M, 2001, BRIT J CANCER, V85, P317; BONNETERRE J, 2001, CANCER, V92, P2247; BONNETERRE J, 2000, J CLIN ONCOL, V18, P3748; BRADY MJ, 1997, J CLIN ONCOL, V15, P974; BUZDAR A, 2000, EUR J CANCER S4, V36, PS82; BUZDAR A, 2001, J CLIN ONCOL, V19, P3357; BUZDAR AU, 1998, CANCER, V83, P1142; COOMBES RC, 2004, NEW ENGL J MED, V350, P1081; CRUCITTA E, 2001, DRUGS TODAY, V37, P639; DEMISSIE S, 2001, J CLIN ONCOL, V19, P322; ERNST DS, 1992, J PAIN SYMPTOM MANAG, V7, P4; FALLOWFIELD LJ, 1999, BREAST CANCER RES TR, V55, P189; GEISLER J, 2002, J CLIN ONCOL, V20, P751; GERSHANOVICH M, 1998, ANN ONCOL, V9, P639; GOSS PE, 1999, ENDOCR-RELAT CANCER, V6, P325; KOBERLE D, 2001, EXPERT REV ANTICANCE, V1, P169; LIU G, 1997, J CLIN ONCOL, V15, P110; MOURIDSEN H, 2001, BREAST CANCER RES TR, V69, P211; MOURIDSEN H, 2001, J CLIN ONCOL, V19, P2596; NABHOLTZ JM, 2000, J CLIN ONCOL, V18, P3758; PFISTER CU, 2001, BIOPHARM DRUG DISPOS, V22, P191; ROSE C, 2002, P AN M AM SOC CLIN, V21, PA34; SANTEN RJ, 1999, ENDOCR-RELAT CANCER, V6, P75; THOMAS R, 1999, CLIN ONCOL-UK, V11, P225; THOMAS R, 2000, EUR J CANCER, V36, P15360OCT857VZLONDONThomas R Cambridge Univ NHS Trust, Addenbrookes Hosp, Hills Rd, Cambridge CB2 2QQ, EnglandCLIN ONCOL-UK84 THEOBALDS RD, LONDON WC1X 8RR, ENGLAND
Keywords: ADVANCED BREAST-CANCER, ANASTROZOLE, AROMATASE INHIBITORS, BREAST, breast cancer, BREAST-CANCER, CANCER, CARCINOMA, FIRST-LINE THERAPY, HORMONAL-THERAPY, LETROZOLE, MEGESTROL-ACETATE, PAIN, PHASE-III, post-menopausal, postmenopausal women, quality of life, QUALITY-OF-LIFE, TAMOXIFEN, TOXICITY, TRIAL, WOMEN
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Cancer Institute
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Cancer Institute > Research Department of Oncology
URI: http://discovery.ucl.ac.uk/id/eprint/36746
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