Preliminary guidance from the UK’s National Institute for Health and Clinical Excellence says that aromatase inhibitors should be used in all postmenopausal women with early breast cancer, adding weight to the widely-held belief that this class of drugs is close to becoming the standard of care in this setting.

Aromatase inhibitors, considered the most significant advance in the early breast cancer therapy since the arrival of tamoxifen three decades ago, are currently used only when the cancer has spread. But if NICE’s recommendation remains unchallenged, the drugs will be endorsed for prescription on the National Health Service with funding in place from November this year, allowing all women in England and Wales access to these therapies immediately after surgery, improving their chances of disease-free survival.

The recommendation is based on data from seven randomised, controlled clinical trials showing treatment with AstraZeneca’s Arimidex (anastrozole), Novartis' Femara (letrozole) and Pfizer's Aromasin (exemestane) is both “clinically beneficial and cost-effective compared with generic tamoxifen,” NICE said in a statement.

Commenting on the decision, Professor Jeff Tobias, Professor of Cancer Medicine, University College London, told PharmaTimes: "I think the new guidance from NICE will be warmly received by patients because it means that, for the first time, there's a strong, if you like, official endorsement of what we, the researchers, have been saying for some time now, which is that anastrozole is a superior agent to tamoxifen, which has stood the test of time for very nearly 30 years. It’s superior both from the point of view of effectiveness and also better tolerated."