New drug 'better than tamoxifen'

Tamoxifen may be replaced as the 'gold standard'

A new drug treatment which gives fresh hope to women with advanced breast cancer may become more widely available in the UK by the end of the year.

The drug, Femara (letrozole) has been shown to have better results than the widely-used "gold-standard" tamoxifen in those women with advanced disease.

Clinical trials have shown that, taken as a once-a-day pill, Femara led to a reduction in the size of tumours and controlled the spread of disease for longer than tamoxifen.

Femara is currently licensed for use in post-meonpausal women in whom treatment with tamoxifen has failed, but oncologists are hopeful that it will be granted a new licence for use as a first line therapy.

Eventually they believe it could be used as tamoxifen is now, including treatment of women with early stage cancer.

Cost is eight times higher

The problem with that may be cost as much as efficacy - it currently costs roughly eight times the price of tamoxifen.

Both drugs act on oestrogen in the body, with tamoxifen preventing oestrogen from binding with cancer cells and Femara preventing the production of oestrogen before eventually killing off malignant cells.

It acts on tumours that are hormone sensitive - around three quarters of the 33,000 new breast cancer cases diagnosed in the UK each year.

Dr Stephen Johnston, a consultant medical oncologist at London's Royal Marsden Hospital and one of the team who developed the drug described trial results as "very exciting".

"It represents a real benefit because we can say to patients that there is a treatment that can control their cancer for longer," he said.

Tamoxifen can generally control the progression of advanced breast cancer for around six months, before cells become reisistant and the tumour begins to grow again.

It represents a real benefit because we can say to patients that there is a treatment that can control their cancer for longer

Dr Stephen Johnston

Results of two trials using Femara, manufactured by Novartis, were presented to the European Breast Cancer conference in Brussels.

In one trial of over 900 patients Femara delayed disease progression by more than nine months.

In a second trial 55% of women with large tumours who were prescribed Femara experienced a 50% reduction in tumour size in four months compared with 36% of those women taking tamoxifen.

Delyth Morgan, chief executive of Breakthrough Breast Cancer welcomed the possibility of extending the licence as giving women with breast cancer more options.

"Such research must continue so the full potential can be validated," she said.

Side effects of Femara are familiar to those of tamoxifen including nausea and hot flushes.