Press Release

Birmingham, 6 October 2008 – Postmenopausal women in the UK could be unknowingly missing out on optimal follow-up treatment for breast cancer, according to research presented today at the annual National Cancer Research Institute (NCRI) Cancer Conference. Over 70 per cent of 100 leading breast cancer hospitals have failed to conduct audits which would ensure that suitable women are getting access to an aromatase inhibitor (AI) after being on tamoxifen for two to three years, in line with NICE guidance issued two years ago.
In 2006, NICE issued guidance recommending that postmenopausal women with oestrogen receptor-positive early breast cancer who are currently on tamoxifen are switched to an aromatase inhibitor exemestane (AromasinTM) after two to three years.2 This guidance was based on evidence from the IES trial, which demonstrated that switching to exemestane has been shown to reduce the relative risk of dying by 17 per cent, compared with remaining on tamoxifen for five years.
“It is worrying that only a fifth of high-volume hospitals have undertaken an audit to confirm whether women are getting access to an AI, in line with the NICE guidance,” commented Mr Anthony Skene, Consultant Surgeon, Royal Bournemouth Hospital NHS FT, one of the researchers. “It is standard practice to conduct audits of treatment guidelines at least once a year, but only 10 per cent of those we surveyed had formally reviewed the guidance at least once in the past year.”
The research also found more that more that more than 20 per cent of hospitals have not shared guidelines for the use of AIs with all members of the wider team managing the follow-up treatment of post-menopausal women, and that 12 per cent do not have any guidelines at all.


“From these findings, it’s unlikely that even high-volume hospitals have mechanisms in place to recall women currently on tamoxifen to discuss switching to an AI with them,” continued Mr Skene. “We can assume that women are slipping through the system and not being offered the optimal treatment in line with NICE guidance.”
Dr Mary McCormack, Consultant Clinical Oncologist, University College London, who was also involved in the research, said: “Aromatase inhibitors have given us an additional option in the management of oestrogen-receptor positive breast cancer in postmenopausal women and they have a definite role in line with the NICE guidance. It is important that women are given the opportunity to discuss all treatment options with their doctor.”
The research was conducted amongst 100 breast cancer specialists, from leading UK hospitals seeing an average of 307 breast cancer patients a year.

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For further information, please contact Reynolds-MacKenzie:
Alison MacKenzie / Rachel Harris / Anna Radnavale
Tel: 020 7031 4360 / 4371 / 4404
Email: alison@reynoldsmackenzie.com; rachel@reynoldsmackenzie.com; anna@reynoldsmackenzie.com

Pfizer UK
Phillippa Manning
Communications Manager
Tel: 01737 331 264
Email: philippa.manning@pfizer.com

NOTES TO EDITORS

About the research:
• National telephone research of 100 breast cancer specialists was conducted by Eggington Research Associates Ltd in August 2008, on behalf of Pfizer UK and research authors: Dr Jayeta Chakrabarti, Pfizer UK; Dr Mark Verrill, Northern Institute for Cancer Research, Newcastle General Hospital; Mr Anthony Iain Skene, Royal Bournemouth Hospital NHS FT; Dr Mary McCormack, University College London; and Professor John Wagstaff, South West Wales Cancer Institute, Swansea

• Respondents were 56 medical oncologists and 44 surgeons evenly spread around the UK

• On average, respondents treat 307 patients per year

Exemestane (Aromasin) indication
Exemestane (Aromasin) is indicated for the adjuvant treatment of postmenopausal women with oestrogen-receptor positive invasive early breast cancer, following two to three years of initial adjuvant tamoxifen therapy. It is also licensed for the treatment of advanced breast cancer in patients that have progressed on anti-oestrogen therapy since 1999. The most common side effects of Aromasin are hot flushes, osteoporosis and fatigue.

About Pfizer Oncology:
Pfizer Oncology is committed to advancing the scientific understanding of cancer and to bringing new medicines to address unmet medical needs in cancer patients. Oncology is a research priority for Pfizer, with 22 percent of the company’s research and development investment devoted to discovering and developing innovative therapies for treating breast, colorectal and other cancers.

About the NCRI Cancer Conference:
The National Cancer Research Institute (NCRI) Cancer Conference is the UK’s premier forum for disseminating advances across all aspects of cancer research.

About the NCRI:
The National Cancer Research Institute (NCRI) was established in April 2001. It is a UK-wide partnership between the government, charity and industry which promotes co-operation in cancer research among the 21 member organisations for the benefit of patients, the public and the scientific community. www.ncri.org.uk
NCRI members are: the Association of the British Pharmaceutical Industry (ABPI); Association for International Cancer Research; Biotechnology and Biological Sciences Research Council; Breakthrough Breast Cancer; Breast Cancer Campaign; Cancer Research UK; CHILDREN with LEUKAEMIA, Department of Health; Economic and Social Research Council; Leukaemia Research; Ludwig Institute for Cancer Research; Macmillan Cancer Support; Marie Curie Cancer Care; Medical Research Council; Northern Ireland Health and Social Care (Research & Development Office); Roy Castle Lung Cancer Foundation; Scottish Government Health Directorates (Chief Scientist Office); Tenovus; Welsh Assembly Government (Wales Office of Research and Development for Health & Social Care); The Wellcome Trust; and Yorkshire Cancer Research.

1. National telephone survey of 100 surgeons and oncologists conducted by Eggington Research Associates Ltd on behalf of Pfizer UK and research authors: Dr Jayeta Chakrabarti, Pfizer UK; Dr Mark Verrill, Northern Institute for Cancer Research, Newcastle General Hospital; Mr Anthony Iain Skene, Royal Bournemouth Hospital NHS FT; Dr Mary McCormack, University College London; and Professor John Wagstaff, South West Wales Cancer Institute, Swansea
2. National Institute of Clinical Excellence, Final Appraisal Determination. ‘Hormonal therapies for the adjuvant treatment of early oestrogen-receptor-positive breast cancer’: http://www.nice.org.uk/ Accessed August 2006
3. Randomised trial of exemestane versus tamoxifen after 2-3 years tamoxifen therapy: Survival and safety in the Intergroup Exemestane Study (IES), Coombes et al, The Lancet, February 2007