Letrozole (CGS 20267), A New Oral Aromatase Inhibitor for the Treatment of Advanced Breast Cancer in Postmenopausal Patients

Letrozole is a new orally, active, potent, and highly specific non-steroidal aromatase inhibitor. Letrozole is about 200 and 10000 times as potent as aminoglutethimide (AG) in vitro and in vivo, respectively. Letrozole was tested in healthy men and postmenopausal women and in postmenopausal patients with advanced breast cancer (ABC). Levels of circulating estrogens decreased by more than 75 to 95% from pre-treatment levels have been observed in patients treated with daily doses of 0.1 to 5 mg letrozole. No clinically relevant changes in other hormones of the endocrine system were found. In four phase Ib/IIa trials, letrozole has shown anti-tumor activity in postmenopausal patients with ABC previously treated with hormonotherapy and/or chemotherapy. Letrozole was well tolerated. Phase IIb/III studies are on going to compare two doses of letrozole with megestrol acetate or AG in order to confirm the anti-tumor efficacy of letrozole in the treatment of ABC in postmenopausal patients who progressed/relapsed following treatment with anti-estrogens.