Verschreibungsverhalten von Aromataseinhibitoren in der adjuvanten endokrinen Therapie des Mammakarzinoms – eine aktuelle Bestandsaufnahme unter Meinungsbildnern in Deutschland

INTRODUCTION: Aromatase inhibitors (AI) are an important therapeutic option for adjuvant endocrine therapy in postmenopausal breast cancer patients. Recently, important clinical randomized studies demonstrated the effectiveness of AI, leading to change in the recommendations issued by medical associations and consensus conferences with preference being given to the administration of AI compared to tamoxifen alone. METHODS: We conducted an anonymous survey of breast specialists on advisory boards to determine the prescription pattern of AI in Germany. Seventy-four physicians took part in the survey. RESULTS: 31 000 patients with breast cancer are treated annually in the institutions of the physicians surveyed. Adjuvant AI therapy for postmenopausal breast cancer was administered in 74 % of patients with national health insurance (NHI) and in 74 % of patients with private health insurance (PHI). The regional prescription rates were as follows (for NHI/PHI): North: 71/77 %, East: 73/66 %, South: 76/76 %, West: 74/75 %, new federal states 73/65 %, old federal states 74/76 %. There were no statistically significant regional differences. In upfront therapy, 82 % of the surveyed doctors prescribe AI therapy with preference given to anastrozole and letrozole. In early sequence therapy, 90 % of the surveyed physicians opted for an AI, usually exemestane and anastrozole. In extended adjuvant therapy, 86 % of the surveyed doctors prescribed AI therapy with preference given to letrozole. There were no statistically significant differences. CONCLUSIONS: The prescription pattern of AI in Germany corresponds to the recommendations of medical societies and consensus conferences. Tamoxifen is no longer the gold standard in the adjuvant endocrine treatment of postmenopausal breast cancer patients and is increasingly replaced by AI administration.