Fulvestrant is FDA indicated for the treatment of hormone receptor positive metastatic breast cancer in postmenopausal women with disease progression following anti-estrogen therapy. (Faslodex)Fulvestrant is a hormonal treatment that works differently than other hormonal treatments. It acts not by competing with estrogen but by selectively down modulating it and causing it to be degraded and disappear. It used to be thought that this unique mechanism of action gives fulvestrant greater efficacy than other hormonal treatments but that does not appear to be the case. Four comparative clinical trials showed similar efficacy to the other hormonal agents (aromatase inhibitors and tamoxifen) with good tolerability profile. Nevertheless, Fulvestrant provided effective second-line therapy in this setting for postmenopausal women who had relapsed or progressed after previous endocrine therapy.
One might wonder then if fulvestrant has anything to recommend it in first line, especially since it is very often used in that line. For this reason,creating quite a stir, the U.K. National Institute for Health and Clinical Excellence (NICE) said in 2011 that it found no evidence Faslodex was significantly better than existing treatments, and it did not recommend its routine use in the country’s National Health Service. It is a more convenient drug in some situations, since it is an injectable drug that is administered once monthly. There are patients, especially in institutional setting, such as nursing homes, for whom once monthly fulvestrant is more realistic than either IV or daily oral drugs.
Fulvestrant In combinations is discussed in the Professional version.
For Professional version see here