337P - Neoadjuvant hormonotherapy with toremifene vs. letrozole of postmenopausal breast cancer patients

Date 27 September 2014
Event ESMO 2014
Session Poster Display session
Topics Cytotoxic agents
Breast Cancer
Biological therapy
Presenter Sergiy Azatyan
Citation Annals of Oncology (2014) 25 (suppl_4): iv110-iv115. 10.1093/annonc/mdu328
Authors S.K. Azatyan1, N.V. Lubenets2, V.A. Kosse3, N.G. Shapirko4, V.I. Probachay2
  • 1Polyclinic Dept., Railway Clinical Hospital, 49000 - Dnipropetrovsk/UA
  • 2Chemotherapy Dept., Clinical Oncological Dispensary, Dnipropetrovsk/UA
  • 3Chair Of Oncology, Dnipropetrovsk Medical Institute, Dnipropetrovsk/UA
  • 4Polyclinic Dept., Railway Clinical Hospital, Dnipropetrovsk/UA



Our small randomized study was conducted to compare the efficacy and adverse effects of neoadjuvant treatment with toremifene vs. letrozole in postmenopausal women with locally advanced “luminal A” type breast cancer. The P024 trial (Ellis MJ, 2007) indicated that letrozole was safe and superior to tamoxifen (toremifene is included in the SERM group too) in the neoadjuvant treatment of the women with such diagnosis. Japanese authors (Sawaki M, Yamamoto Y, 2010-2013) published some articles about clinical usefulness of high-dose toremifene (120mg) in patients relapsed on treatment with an aromatase inhibitor.


Eighty-nine postmenopausal women with ER and/or PgR positive T3-4 N1-3 breast cancer were randomly assigned to treatment with either toremifene 120 mg/day or letrozole 2.5 mg/day for four months. None of the patients was considered to be a candidate for breast-conserving surgery (BCS) at baseline. 27% of the patients were considered inoperable. We planned to compare overall objective response (CR + PR) on ultrasound and CT and also the number of patients who qualified for BCS.


Overall response rate by ultrasound was statistically superior in the toremifene group, 65% compared with the letrozole, group 54% (P = 0.054).Overall response rate measured by CT was 49% vs. 39% (P = 0.079). Possibility of BCS was 24% vs. 19% (P = 0.112). Both treatments were well tolerated and adverse effects were rare and not more than grade 1 by CTCAE v4.0.


Our study shows that high-dose toremifene is more effective than letrozole as neoadjuvant hormonetherapy in postmenopausal patients with “luminal A” type breast cancer and that both are well tolerated.


All authors have declared no conflicts of interest.