Longer Use of Certain Drugs Cuts Recurrence for Breast Cancer Survivors
The research involved more than 1,900 postmenopausal women with primary breast cancer who had received 4.5-6 years of adjuvant therapy with an aromatase inhibitor, preceded in most cases by treatment with tamoxifen.
Clinicians knew from previous studies that using tamoxifen for up to 10 years was better than using it for five years, but there wasn't corresponding data for aromatase inhibitors.
A number of small studies looking at the benefits of exercise and weight loss on cancer by researchers at Yale University in the USA are being presented at the American Society of Clinical Oncology meeting (ASCO) in Chicago.
The results, which have also been published in the New England Journal of Medicine, have been widely praised as significant.
"The study will have an enormous impact; a reduction in recurrences is a very important finding".
'It should therefore become the new standard of care'.
But some experts were cautious about predicting changes in treatment strategies.
Most breast cancers are hormone receptor-positive, meaning tumor growth can be fueled by the hormones estrogen or progesterone.
The study, led by the University of Navarra in Pamplona and the Spanish Biomedical Research Centre in Physiopathology of Obesity and Nutrition in Madrid, Spain, compared women whose families consumed one litre a week of olive oil, compared with women on a low fat diet.
"Extended letrozole [an aromatase inhibitor] in years 10-15 has benefit in preventing a new breast cancer diagnosis". "These were both small studies and one always needs to wait for the peer-reviewed publications", he added. The first group was given daily pill of letrozole for an additional of five years, while the other group was given placebo.
After a median follow-up of 6.3 years, researchers noted a total of 165 recurrences or occurrence of cancer on the other breast. Of those, 67 were in the letrozole group while 98 were in the placebo group. "The validation of BCI for node-positive patients means that some of these patients who have already undergone chemotherapy and five years of endocrine therapy, will have a tool that will allow them to work with their doctor to weigh the potential benefits of extended endocrine therapy vs. the potential risks".
A large trial is being launched this summer to establish whether diet and exercise regimes should be prescribed by doctors for women who have had breast cancer in the same way that they prescribe drugs, to prevent the disease returning and potentially save lives. Looked at another way, 95 percent of the women in the letrozole group experienced disease-free survival for five years, compared with 91 percent in the placebo group.
"These data are important for the almost 20% of ER+ breast cancer patients that are node-positive with 1-3 positive lymph nodes, and are generally considered to have a high risk of recurrence", said Lee Schwartzberg, MD, Chief, Division of Hematology & Oncology, University of Tennessee Health Science Center.
"These data are important to millions of women around the world", Dr. Harold Burstein, a breast cancer expert and spokesman for the American Society of Clinical Oncology, said in a statement on Sunday. But he said he expected there to be "tremendous interest" in the study.
Source: Irene Delgado @Wingate Wire.compostmenopausal women, primary breast cancer, adjuvant therapy, tamoxifen