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Table 2 Comparison of aromatase inhibitors and fulvestrant

From: Neoadjuvant endocrine therapy in locally advanced estrogen or progesterone receptor-positive breast cancer: determining the optimal endocrine agent and treatment duration in postmenopausal women—a literature review and proposed guidelines

Study Duration (months) Dose (mg/day) No. of patients Study outcomes Assessment
Z1031 trial. Ellis et al. 2011 and 2017 [53, 54] 4 Exemestane 25 or letrozole 2.5 or anastrozole 1 377 1. pCR: 1.6% (AI 16 weeks); 5.7% (switched to chemotherapy at 2 weeks)
2. ORR (clinical palpation): 62.9% exemestane; 74.8% letrozole; 69.1% anastrozole.
3. BCS: 51% (patients mastectomy at baseline); 83% (patients marginal for BCS)
Monthly physical examination, toxicity assessment, and tumor assessment.
CARMINA 02 Lerebours et al. 2016 [28] 4 or 6 Anastrozole 1 or fulvestrant 500 mg/month 116 1. pCR: NR.
2. ORR (clinical palpation): 52.6% anastrozole; 36.8% fulvestrant.
3. BCS: 57.6% anastrozole; 50% fulvestrant (p = 0.5)
Clinical assessment, ultrasound, and MRI at baseline, 1 month, and 4 months.
Grassadonia et al. 2014 [65] Mean 5.7 Anastrozole 1 or exemestane 25 or letrozole 2.5 144 1. pCR: 1.4%
2. ORR (clinical palpation): 86.6% (9.6% CR and 77% PR)
3. BCS: 84% (ineligible for BCS at baseline)
Caliper measurement at baseline, monthly, and before surgery.
FIRST Robertson et al. 2009 [66] Until progression Anastrozole 1 or fulvestrant 500 mg/month 205 1. pCR: NR.
2. ORR (clinical palpation): 35.5% anastrozole; 36% fulvestrant (p = 0.947)
3. BCS: NR.
Clinical and radiological tumor assessment every 12 ± 2 weeks until progression.
  1. BCS breast-conserving surgery, pCR pathological complete response, ORR objective response rate, CR complete response, PR partial response, NR not reported. See Additional file 1, Table S2 for definitions