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Ana4.6
Anastrozole Research
Mostly mechanism / observational
33 peer-reviewed studies
What the evidence says
Mostly mechanism / observational
Most Anastrozole studies are mechanism or observational rather than RCTs that measure a clinical effect — keep findings provisional.
Most evidence is from high-quality meta-analyses and randomised trials published 2005–2026 with a typical study size of 212 participants.
Based on 33 studies · 4 meta-analyses · 28 RCTs · 30,484 total participants
Confidence
High confidence
By outcome
Breast cancer (approved)
Mostly mechanism / observational22 studies
Testosterone & male hormonesReliably increases endogenous testosterone and modestly lowers estradiol in older and obese hypogonadal men · Weeks of daily dosing
Mostly mechanism / observational11 studies
Bone health (trade-off)
Mostly mechanism / observational5 studies
Safety profile
Mostly mechanism / observational3 studies
Fertility & reproductive
Too few graded studies1 study
Active research area
11 studies in the last 5 years · Latest meta-analysis: 2025
200520152026
1Meta-Analysisn=8,482 · very large study2025
In plain English: Although newer combination therapies are being adopted, the agents explored in this review are still widely used in clinical practice for HR+ BC.
Okwor VC, Okwor JC, Ukwuoma MK, Mitha SB, Nweke MC. · Medical principles and practice : international journal of the Kuwait University, Health Science Centre (2025)
ORR and PFS between aromatase inhibitors (AIs) and other hormonal therapies: selective oestrogen receptor degrader, selective oestrogen modulator (SERM) and androgen inhibitors showed no significant difference (OR = 1.122 [0.917-1.374], p = 0.263; OR = 0.010 [0.000-1.292], p = 0.063), respectively.
Subgroup analysis showed a statistically significant difference in ORR in favour of patients who received SERM compared to AI (OR = 1.362 [1.033-1.795], p = 0.028).
For OS, no significant difference was observed among anastrozole, letrozole, and exemestane recepients (OR = 1.718 [0.021-139.128], p = 0.809).
In plain English: However, BMI should be considered in anastrozole therapy due to differential effects on DFS and adverse events.
Lin X, Sun H, Wei X, Xie M, Chen L, Hu CT, Cai J. · Clinical nutrition ESPEN (2025)
Normal-weight patients on tamoxifen had a greater risk of bone pain (RR = 1.25, P = 0.03).
Further MR analysis revealed no causal link between BMI and 5-year or 15-year survival rates in endocrine-treated patients (5-year HR = 0.7923, 95 % Confidence Interval (CI)[0.2053, 3.0581], P = 0.7355; 15-year HR = 0.9793, 95 % CI [0.7121, 1.3469], P = 0.898).
Conclusion Current meta-analysis and MR findings suggest no significant link between BMI and the overall efficacy of endocrine therapy in breast cancer.