S0226 compared anastrozole to anastrozole plus fulvestrant loading dose in first-line treatment of metastatic ER-Positive Breast Cancer. The combination arm was more effective than anastrozole alone, with a significant improvement in PFS and OS. This concept of complete ER blockade has been an attra...

S0226 is the only phase-III study to show overall survival advantage in first-line, largely endocrine-naïve patient population, currently. FACT required patients to be in first relapse; therefore, included largely endocrine-pretreated population, with more endocrine-pretreat...

Although I acknowledge that the results are quite good with combination, most of our group has pursue the path of CDK 4,6 Inhibitors together with AI with no direct comparison available