Ribociclib Active Across Premenopausal Breast Cancer Subgroups

Excerpt:

“The progression-free survival (PFS) benefit for ribociclib (Kisqali) in pre- or perimenopausal women with hormone receptor–positive, HER2-negative advanced or metastatic breast cancer was sustained across patient subgroups, according to findings from the phase III MONALEESA-7 trial presented at the 2018 Miami Breast Cancer Conference.

“MONALEESA-7 randomized patients to either the CDK4/6 inhibitor ribociclib in combination with tamoxifen or a nonsteroidal aromatase inhibitor (NSAI; letrozole or anastrozole) plus goserelin (n = 335), or to endocrine treatment plus goserelin (n = 337). Across the overall study population, the median PFS was 23.8 months for the ribociclib arm compared with 13.0 months for the control arm (HR, 0.553; 95% CI, 0.441-0.694; P <.0001).”

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FAQs After Diagnosis: Early Stage Hormone-Positive Breast Cancer


This post is written by ASK Cancer Commons Scientist and Product Team Member Amanda Nottke, PhD. Dr. Nottke regularly provides guidance to patients through our ASK Cancer Commons service.

After a diagnosis of early stage, hormone-positive breast cancer, you may find yourself facing several daunting decisions, such as choosing between the extensive surgery of mastectomy versus a more minor lumpectomy procedure paired with radiation (with all its challenging side effects). And once surgery is complete, what next? Hormone therapy is clearly indicated for many women, but which drug, and how long to take it? And what about chemo—how to know if the tough side effects are worth the possible reduction in risk of recurrence?

Fortunately, there are a wealth of quality datasets available to inform these decisions. Below are some of the questions we get most frequently from patients using our ASK Cancer Commons service, answered according to the latest thinking from scientific literature and our expert physician network. If you are facing your own cancer treatment decisions and would like free one-one-one expert support, please submit your case here.

1. If my doctor has said either mastectomy or lumpectomy plus radiation are appropriate for me, how do I choose?

Many studies have looked at this, and overall the outcomes for mastectomy versus lumpectomy plus radiation are extremely similar (both are effective treatments, so you can instead weigh the side effects of radiation versus the more intensive surgery of the mastectomy). This webpage provides a helpful summary of the pros and cons of mastectomy compared to lumpectomy. Continue reading…


Understanding When Eating Soy Might Help or Harm in Breast Cancer Treatment

Excerpt:

“Georgetown Lombardi Comprehensive Cancer Center researchers have used animal models to reveal new information about the impact – positive and negative – that soy consumption could have on a common breast cancer treatment.

“The scientists have uncovered the biological pathways in rats by which longtime soy consumption improves effectiveness of tamoxifen and reduces recurrence. But they also show why eating or drinking soy-based foods for the first time while being treated with tamoxifen can, conversely, reduce effectiveness of the drug, and promote recurrence.

“The study, published in Clinical Cancer Research, uncovers the molecular biology behind how soy consumption, especially its most active isoflavone, genistein, affects tamoxifen—both positively and negatively.”

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If you’re wondering whether this story applies to your own cancer case or a loved one’s, we invite you to use our ASK Cancer Commons service.


Naturally Occurring Symptoms May Be Mistaken for Tamoxifen Side-Effects

Excerpt:

“Women taking tamoxifen to prevent breast cancer were less likely to continue taking the drug if they suffered nausea and vomiting, according to new data presented at the San Antonio Breast Cancer Symposium today (Friday).

“The researchers found that women who experienced these symptoms after starting tamoxifen as part of the Cancer Research UK funded International Breast Cancer Intervention Study (IBIS-1), were more likely to stop taking the medication.

“But this new analysis also reveals that women given a placebo who experienced the same symptoms were equally as likely to stop. This suggests that some symptoms due to other causes, were being mistaken for side effects of tamoxifen.”

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If you’re wondering whether this story applies to your own cancer case or a loved one’s, we invite you to use our ASK Cancer Commons service.


Tamoxifen Linked to Reduced Contralateral Breast Cancer Risk

Excerpt:

“Use of tamoxifen and aromatase inhibitors during and after breast cancer treatment were found to reduce the risk of contralateral breast cancer in a community healthcare setting, according to a study published in JAMA Oncology.

“The authors of the real-world retrospective study found that among estrogen receptor (ER)-positive breast cancer patients who survived at least 5 years, tamoxifen use for 4 years or more prevented an estimated three contralateral breast cancer cases for every 100 women by year 10. This absolute risk reduction is consistent with prior results from tamoxifen clinical trials, according to study authors led by Gretchen L. Gierach, PhD, MPH, of the division of cancer epidemiology and genetics at the National Cancer Institute.”

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If you’re wondering whether this story applies to your own cancer case or a loved one’s, we invite you to use our ASK Cancer Commons service.


No Increased Risk of Fatal CV Events for Breast Cancer Patients on Newer Hormone Therapy

Excerpt:

“In a new study from Kaiser Permanente, researchers found the use of aromatase inhibitors, hormone-therapy drugs used to treat patients with breast cancer, was not associated with an increased risk of fatal cardiovascular events, including heart attacks or stroke, compared with tamoxifen, another commonly prescribed anti-cancer drug that works on hormones and which has been associated with a serious risk of stroke.

“While women taking aromatose inhibitors did not have an increased risk of death from heart attacks or stroke, the study, published today in JAMA Oncology, found that those who only used aromatase inhibitors or used the drugs after tamoxifen treatment had a 26 to 29 percent higher risk of less serious cardiovascular events, such as abnormal heart beat and pericarditis (a swelling and irritation of the thin membrane surrounding the heart), compared with those who only used tamoxifen.”

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Do you have questions about this story? Let us know in a comment below. If you’re wondering whether this story applies to your own cancer case or a loved one’s, we invite you to use our Ask Cancer Commons service.


Aromasin Plus OFS May Reduce Risk of Recurrent Breast Ca (CME/CE)

Excerpt:

“Premenopausal women with hormone receptor-positive, HER2-negative breast cancer may benefit from exemestane (Aromasin) plus ovarian function suppression (OFS) versus tamoxifen with or without OFS, analysis of recurrence-risk data from the TEXT and SOFT trials has indicated.

“Those with a high recurrence risk may experience a 10% to 15% improvement in the 5-year breast cancer-free interval (BCFI) with aromatase inhibitor (AI) exemestane plus OFS, while those at intermediate risk may experience an improvement of at least 5% with the same regimen, according to Meredith M. Regan, ScD, of Dana-Farber Cancer Institute in Boston, MA, and colleagues.

“Patients at lowest risk of recurrence had minimal benefit with exemestane plus OFS, the study showed, which is online in the Journal of Clinical Oncology.”

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Do you have questions about this story? Let us know in a comment below. If you’re wondering whether this story applies to your own cancer case or a loved one’s, we invite you to use our Ask Cancer Commons service.


ESMO Asia 2015 News: Endocrine Therapy in Premenopausal Women: Selecting Patients, Treatments and Durations

“Prudence Francis, from the Peter MacCallum Cancer Centre in Melbourne, Victoria, Australia, discussed which endocrine therapy is best for young, premenopausal patients.

“She noted that the key differentiating factor in order to decide on a treatment option in this patient population is the risk of recurrence, and cited the findings of the Suppression of Ovarian Function Trial (SOFT) as well as those of a joint analysis of SOFT and the Tamoxifen and Exemestane Trial (TEXT).

“In the SOFT trial, patients were randomly assigned to receive one of three regimens for 5 years: tamoxifen alone; tamoxifen plus ovarian function suppression (OFS; via treatment with the gonadotropin-releasing-hormone agonist triptorelin, oophorectomy or irradiation); or tamoxifen with OFS and the aromatase inhibitor exemestane.”


Two Drugs Equal For Early Breast Cancer

“Postmenopausal women who have an early, noninvasive form of breast cancer had similar recurrence rates of disease whether they took the drug tamoxifen or the aromatase inhibitor anastrozole after surgery, new research shows.

“However, the side effects of the two medications differed greatly, said study author Jack Cuzick, director of the Wolfson Institute of Preventive Medicine at Queen Mary University of London, England.

“His team looked at nearly 3,000 women, all past menopause, who had hormone-receptor positive ductal carcinoma in situ (DCIS) breast cancer and underwent surgery to excise it. With DCIS, the cells that line the milk ducts have changed but not spread into the surrounding breast tissue.”