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Fulvestrant (Faslodex, AstraZeneca) is a drug treatment of hormone receptor-positive metastatic breast cancer in postmenopausal women with disease progression following anti-estrogen therapy. It is a complete estrogen receptor antagonist with no agonist effects, which in addition, accelerates the proteasomal degradation of the estrogen receptor.
Fulvestrant is a selective estrogen receptor down-regulator (SERD). Fulvestrant is indicated for the treatment of hormone receptor positive metastatic breast cancer in postmenopausal women with disease progression following anti-estrogen therapy. The dosing schedule for fulvestrant remains under investigation in an attempt to optimize its effectiveness.
Metastatic or locally advanced breast cancer
Fulvestrant provided effective second-line therapy in this setting for postmenopausal women who had relapsed or progressed after previous endocrine therapy.
In particular 4 clinical trials in this setting did show similar efficacy to the other hormonal agents (aromatase inhibitors and tamoxifen) with good tolerability profile. Fulvestrant had a lower incidence of joint disorders.
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, so its widespread use would not be a good use of resources for the country's National Health Service
The first month's treatment of Faslodex, which starts with a loading dose, costs £1,044.82 ($1,666), and subsequent treatments cost £522.41 a month.
The original patent for Faslodex expired in October 2004. Drugs subject to pre-marketing regulatory review are eligible for patent extension, and for this reason AstraZeneca got an extension of the patent to December 2011.
- Scott SM, Brown M, Come SE (2011). "Emerging data on the efficacy and safety of fulvestrant, a unique antiestrogen therapy for advanced breast cancer". Expert Opin Drug Saf 10 (5): 819–26. doi:10.1517/14740338.2011.595560. PMID 21699443.
- Angela Mae Obermiller, PharmD; and Mehmet Sitki Copur, MD (2011). "The Longstanding Quest for a Better Endocrine Therapy Continues High-Dose Fulvestrant: Have We Found Its Effective Dose, Combination, Setting, or Sequence?". Contemporary Oncology 3 (1).
- Croxtall JD, McKeage K (2011). "Fulvestrant: a review of its use in the management of hormone receptor-positive metastatic breast cancer in postmenopausal women". Drugs 71 (3): 363–80. doi:10.2165/11204810-000000000-00000. PMID 21319872.
- Valachis A, Mauri D, Polyzos NP, Mavroudis D, Georgoulias V, Casazza G (2010). "Fulvestrant in the treatment of advanced breast cancer: a systematic review and meta-analysis of randomized controlled trials". Crit. Rev. Oncol. Hematol. 73 (3): 220–7. doi:10.1016/j.critrevonc.2009.03.006. PMID 19369092.
- Flemming J, Madarnas Y, Franek JA (2009). "Fulvestrant for systemic therapy of locally advanced or metastatic breast cancer in postmenopausal women: a systematic review". Breast Cancer Res. Treat. 115 (2): 255–68. doi:10.1007/s10549-008-0137-8. PMID 18683044.
- UK Department of Health Commercial Medicines Unit Electronic Medicines Information Tool, London, 2015
- UK’s NICE says no to AstraZeneca breast cancer drug Faslodex, The Pharma Letter, 10 November 2011
- National Institute for Health and Clinical Excellence Guidance Breast cancer (metastatic) - fulvestrant
- Patent Term Extensions The United States Patent and Trademark Office.
- Determination of Regulatory Review Period for Purposes of Patent Extension; FASLODEX A Notice by the Food and Drug Administration on 04/17/2003
- Generic Faslodex Availability, Drugs.COM
- Pink Ribbon Blues: How Breast Cancer Culture Undermines Women's Health By Gayle A. Sulik, Oxford University Press (Oct. 2010)