NEWS

In Brief

Aromatase Inhibitor After Tamoxifen Improves Disease-Free Survival

Postmenopausal breast cancer patients who took the aromatase inhibitor exemestane after 2 to 3 years of tamoxifen had a reduced chance of recurrence and increased disease-free survival compared with patients who remained on tamoxifen, according to results from the Intergroup Exemestane Study.

Taking tamoxifen after treatment for breast cancer reduces a woman’s risk for recurrence of the disease; however, after 5 years of therapy, the risks of the drug may begin to outweigh its benefits. There are several ongoing studies of alternative endocrine therapy. One class of drugs, aromatase inhibitors, has shown promise in preventing disease relapse.

The Intergroup Exemestane Study included more than 4,700 postmenopausal women in 37 countries with breast cancer who were followed for an average of 31 months. After 2 to 3 years of adjuvant tamoxifen therapy, patients were randomly assigned to receive either 25 mg of exemestane or to continue on tamoxifen (20 mg) daily.

Patients receiving exemestane experienced a 32% reduction in the risk of recurrence of the disease at 3 years compared with those continuing on tamoxifen. The investigators calculated that this translated to a 4.7% improvement in disease-free survival. This reduction included fewer cases of metastatic disease as well as fewer contralateral breast cancers. There was no difference in overall survival between the two groups, but the authors point out that this is a second interim analysis of the trial and the trial has not yet reached its planned end.

The study, which was published in the March 11 issue of the New England Journal of Medicine, was sponsored by Pfizer, the makers of exemestane.

See News, Vol. 94, No. 7, p. 474, "Upstaging Tamoxifen? New Classes of Drugs Emerging for Breast Cancer."

Investigators Characterize Colorectal Cancer Among WHI Participants

Researchers have found that estrogen plus progestin use was associated with a decreased risk of colorectal cancer among postmenopausal women in the Women’s Health Initiative (WHI) trial of combination hormone replacement therapy with estrogen plus progestin. However, the cancers diagnosed among hormone takers were at a more advanced stage than those in women who took a placebo.

In July 2002, WHI researchers reported a 26% increase in breast cancer for postmenopausal women taking estrogen plus progestin. In June 2003, researchers reported that the combination hormone therapy may also stimulate breast cancer growth and delay breast cancer diagnosis. In this current study, researchers concluded that short-term use of estrogen plus progestin is associated with decreased incidence of colorectal cancers. Investigators sought to analyze the features of the colorectal cancers that developed among those women.

They found that women who took estrogen plus progestin had a 44% decreased risk of colorectal cancer. The invasive colorectal cancers had similar histologic characteristics in both groups, but the cancers diagnosed among women in the hormone group had a greater number of positive lymph nodes and were more advanced.

"These findings support wider implementation of bowel screening among postmenopausal women who are using hormone therapy," the authors wrote.

The study was published in the March 4 issue of the New England Journal of Medicine.

See News, Vol. 95, No. 1, p. 9, "NIH Workshop Tries to Create Consensus on HRT Use."



             
Copyright © 2004 Oxford University Press (unless otherwise stated)
Oxford University Press Privacy Policy and Legal Statement