Fulvestrant in the treatment of advanced breast cancer: a systematic review and meta-analysis of randomized controlled trials

Crit Rev Oncol Hematol. 2010 Mar;73(3):220-7. doi: 10.1016/j.critrevonc.2009.03.006. Epub 2009 Apr 14.


Purpose: To compare efficacy and tolerability of fulvestrant with aromatase inhibitors and tamoxifen that actually represent the standard of care in hormone-sensitive breast cancer.

Methods: Systematic review and meta-analysis of available trials. Primary outcomes were overall survival, time to progression, clinical outcome and objective response. Secondary outcome was the tolerability profile of the drugs.

Results: Four trials were identified with 2125 eligible patients. There was no statistically significant difference between fulvestrant and other hormonal agents in terms of overall survival (pooled HR: 1.047, 95% CI: 0.688-1.592), time to progression (pooled HR: 0.994, 95% CI: 0.691-1.431), clinical benefit (pooled OR: 1.044, 95% CI: 0.828-1.315) or objective response rate (pooled OR: 0.949, 95% CI: 0.736-1.224). A higher incidence of joint disorders (pooled OR: 0.621, 95% CI: 0.424-0.909; P=0.014) was noted in patients receiving hormonal agents other than fulvestrant.

Conclusion: Fulvestrant was similar to other hormonal agents with respect to efficacy measures, with good tolerability profile.

Publication types

  • Comparative Study
  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Antineoplastic Agents, Hormonal / therapeutic use*
  • Aromatase Inhibitors / therapeutic use*
  • Breast Neoplasms / drug therapy*
  • Estradiol / analogs & derivatives*
  • Estradiol / therapeutic use
  • Female
  • Fulvestrant
  • Humans
  • Randomized Controlled Trials as Topic
  • Tamoxifen / therapeutic use*


  • Antineoplastic Agents, Hormonal
  • Aromatase Inhibitors
  • Tamoxifen
  • Fulvestrant
  • Estradiol