Endocrine Therapies for Young Breast Cancer Patients Can Cause Abrupt Menopause Symptoms

MedicalResearch.com Interview with:
Dr. Jürg Bernhard Ph.D.

International Breast Cancer Study Group Coordinating Center and Bern University Hospital, Inselspital, Bern, Switzerland

Medical Research: What is the background for this study? What are the main findings?

Response: In the combined analysis of the SOFT and TEXT trials, the aromatase inhibitor exemestane was more effective than tamoxifen in preventing breast cancer recurrence in young women (premenopausal) who also receive ovarian function suppression (OFS) as adjuvant (post-surgery) treatment for hormone-sensitive early breast cancer, providing a new treatment option for these women. These trials were conducted by the International Breast Cancer Study Group (IBCSG) and involved more than 4700 patients of over 500 centers in 27 countries. Now we present patient-reported quality of life outcomes from these trials.

In the TEXT and SOFT trials, patients assigned exemestane+OFS reported more detrimental effects of bone or joint pain, vaginal dryness, greater loss of sexual interest and difficulties becoming aroused, while patients assigned tamoxifen+OFS were more affected by hot flushes and sweats. Global quality of life domains (mood, ability to cope and physical well-being) were similar between the randomized treatment groups.

Medical Research: What should clinicians and patients take away from your report?

Response: From a quality of life perspective, there is no strong indication favoring either exemestane+OFS or tamoxifen+OFS. The different side effects of the two treatments should be considered with each patient, to determine how these symptoms might affect her individually, especially considering the better disease control for one of the treatments.

Medical Research: What recommendations do you have for future research as a result of this study?

Response: Endocrine treatments for premenopausal women can cause menopausal symptoms earlier in their lives than natural menopause, and often more abruptly. These two treatments both cause treatment-induced menopausal symptoms. An early recognition of the impact these symptoms is essential for patient care. Some of the menopausal symptoms can be lessened by a multidisciplinary approach, but there is also a need to develop more safe and effective treatments for menopausal symptoms.

Citation:

Patient-reported outcomes with adjuvant exemestane versus tamoxifen in premenopausal women with early breast cancer undergoing ovarian suppression (TEXT and SOFT): a combined analysis of two phase 3 randomised trials

 Dr Jürg Bernhard, PhD,Weixiu Luo, MD,Karin Ribi, PhD,Marco Colleoni, MD,Harold J Burstein, MD,Carlo Tondini, MD,Graziella Pinotti, MD,Simon Spazzapan, MD,Thomas Ruhstaller, MD,Fabio Puglisi, MD,Lorenzo Pavesi, MD,Vani Parmar, MBBS,Meredith M Regan, ScD,Olivia Pagani, MD,Gini F Fleming, MD,Prudence A Francis, MD,Karen N Price, BS Alan S Coates, MD,Richard D Gelber, PhD,Aron Goldhirsch, MD Barbara A Walley, MD

Lancet Oncology Volume 16, No. 7, p848–858, July 2015

DOI: http://dx.doi.org/10.1016/S1470-2045(15)00049-2

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Dr. Jürg Bernhard Ph.D., & International Breast Cancer Study Group Coordinating Center and Bern University (2015). Endocrine Therapies for Young Breast Cancer Patients Can Cause Abrupt Menopause Symptoms