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SABCS 2017: Can Perioperative Aromatase Inhibitor Treatment Predict Long-Term Outcomes in Early Breast Cancer?

By: Alanna M. Greaney
Posted: Thursday, December 14, 2017

Although the ongoing POETIC trial findings at the 2017 San Antonio Breast Cancer Symposium (SABCS; Abstract GS1-03) offered no support to suggest perioperative aromatase inhibitor therapy slows or prevents time to recurrence of breast cancer, the updated trial data did provide evidence that tumor Ki67 levels after 2 weeks of perioperative aromatase inhibitor therapy may offer an effective way of predicting outcomes and the need for additional adjuvant treatment.

According to John F.R. Robertson, MD, of the University of Nottingham School of Medicine, Darby, UK, and colleagues, their approach with perioperative aromatase inhibitor therapy may enable clinicians to identify a select group of patients for whom the current standard of care appears insufficient in the few years post diagnosis.

In the POETIC trial, postmenopausal patients with early-stage estrogen receptor–positive breast cancer were randomized 2:1 to either a perioperative aromatase inhibitor (letrozole at 2.5 mg or anastrozole at 1 mg daily) or no perioperative aromatase inhibitor. The investigators analyzed 4480 postmenopausal patients, 2976 of whom were placed on aromatase inhibitor therapy and 1504 of whom were given a placebo, over the course of 7 years. To measure the effect on Ki67 tumors, tissue samples were collected at baseline and surgery for blind testing.