Are Estring® and Vagifem® Equally Effective and Safe for the Treatment of Urogenital Atrophy in Breast Cancer Patients on Aromatase Inhibitor Therapy?

Sir — The urogenital side-effects of aromatase inhibitors are well recognised, and can have a significant negative effect on quality of life. Safety issues around the use of oestrogen-based therapies in this patient population remain unanswered [ 1 Morales L. Neven P. Timmerman D. et al. Acute effects of tamoxifen and third-generation aromatase inhibitors on menopausal symptoms of breast cancer patients. Anti-cancer Drugs. 2004; 15: 753-760 Crossref PubMed Scopus (113) Google Scholar , 2 Trinkaus M. Chin S. Wolfman W. Simmons C. Clemons M. Should urogenital atrophy in breast cancer survivors be treated with topical estrogens?. Oncologist. 2008; 13: 222-231 Crossref PubMed Scopus (56) Google Scholar ]. Our group has conducted a trial examining the effectiveness and safety of Vagifem® versus Estring® in the treatment of significant urogenital symptoms in women on aromatase inhibitors with significant urogenital symptoms despite the use of a local non-oestrogen-based moisturising therapy [ [3] A comparative study of Estring and Vagifem in the treatment of urogenital atrophy in breast cancer patients: the EVA study. Protocol ID OCT1172, 00000009. Available at: www.ontariocancertrials.ca. [accessed 20.11.08]. Google Scholar ].