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Treatment of advanced breast cancer in postmenopausal women with disease progression following tamoxifen therapy. Endometrial or uterine cancers (recurrent or metastatic) Hormonal agents such as progestational agents or tamoxifen may be used in the management of recurrent or metastatic endometrial cancer; in select patients, aromatase inhibitors, including anastrozole, may be considered. A small phase II trial evaluated anastrozole in a group of unselected patients with advanced recurrent or persistent endometrial cancer; the results showed minimal activity of anastrozole [Rose 2000]. A retrospective analysis of patients with uterine leiomyosarcoma suggests that, in patients with low disease burden and an indolent course (who are estrogen- or progesterone-receptor positive), hormone blockade with an aromatase inhibitor such as anastrozole may be considered [O’Cearbhaill 2010]. Ovarian cancer (recurrent) Hormonal therapy, including aromatase inhibitors such as anastrozole, may be considered in patients with recurrent ovarian cancer who cannot tolerate or have not responded to other chemotherapy regimens. Data from a small phase II study in patients with ovarian cancer suggests that anastrozole may lead to a response in a small number of patients, and is well tolerated [del Carmen 2003]. Risk reduction for breast cancer in postmenopausal women. Data from a large international, randomized, placebo-controlled, double-blind phase III study (IBIS-II) support the use of anastrozole in the prevention of breast cancer in high-risk postmenopausal women [Cuzick 2014]. Hypersensitivity to anastrozole or any component of the formulation. Canadian labeling: Additional contraindications (not in the US labeling): Pregnancy, breastfeeding. Breast cancer, advanced: Postmenopausal females: Oral: 1 mg once daily; continue until tumor progression. Breast cancer, advanced, estrogen receptor-positive, HER2-negative (off-label combination): Postmenopausal females: Oral: 1 mg once daily (in combination with abemaciclib) until disease progression or unacceptable toxicity (Goetz 2017). Premenopausal or perimenopausal females: Oral: 1 mg once daily (in combination with ribociclib [and the luteinizing hormone-releasing hormone (LHRH) agonist goserelin]) until disease progression or unacceptable toxicity (Tripathy 2018), oral winstrol. Breast cancer, early (adjuvant treatment): Postmenopausal females: Oral: 1 mg once daily. Duration of therapy: The American Society of Clinical Oncology (ASCO) guidelines for Adjuvant Endocrine Therapy of Hormone-Receptor Positive Breast Cancer (Focused Update) recommend a maximum duration of 5 years of aromatase inhibitor (AI) therapy for postmenopausal women; AIs may be combined with tamoxifen for a total duration of up to 10 years of endocrine therapy. Refer to the guidelines for specific recommendations based on menopausal status and tolerability (Burstein 2014). In a phase III study with another AI (letrozole), treatment with an additional 5 years of AI therapy (for a total of 10 years of AI therapy) demonstrated a significantly improved rate of disease-free survival and a decreased risk of disease recurrence and contralateral breast cancer (when compared to placebo), although overall survival was not significantly different between groups and bone-related adverse events occurred more frequently with letrozole versus placebo (Goss 2016). The decision to extend aromatase inhibitor therapy for an additional 5 years should include initial adjuvant therapy (tamoxifen versus an aromatase inhibitor) and an assessment of the risk of recurrence. Breast cancer, risk reduction (off-label use): Postmenopausal females ?40 years of age: Oral: 1 mg once daily for 5 years (Cuzick 2014). Endometrial or uterine cancer, recurrent or metastatic (off-label use): Oral: 1 mg once daily (Rose 2000). Ovarian cancer, recurrent (off-label use): Oral: 1 mg once daily until disease progression or unacceptable toxicity (del Carmen 2003). Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information. ARIMIDEX 1 mg is a prescription hormonal treatment that helps fight breast cancer by lowering the amount of estrogen in the body. ARIMIDEX is a selective, non-steroidal aromatase inhibitor, which signifcantly lowers serum estradiol (estrogen) concentrations, without interfering with the formation of adrenal corticosteroids or aldosterone.
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