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How Long Should Women Take Anti Estrogen Drugs

Posted 12/13/2016

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  This was some of the biggest news/non-news from the recent San Antonio Breast meeting. As many of you know, the trend over recent years has been to extend the length of time that women with ER positive breast cancers take a hormonal/anti-estrogen therapy. This usually has translated to ten years, rather than the earlier five year standard, of either sequential Tamoxifen and then an AI or totally an AI.

  I began this entry with the phrase news/non-news. When I spoke with my husband who was at the meetings, he described these three reported studies as big news. His overall take was that the extension of hormonal therapy will no longer be automatic, a one size fits all approach, but will be individualized for the woman's particular situation. Specifically, he reported that women who had larger tumors and positive nodes likely would continue for longer while others might not. In other words, this will become a talk with your doctor situation. And that is always a good thing.

  This article from Medscape seems to put the reports more in the non-news category. See what you think.

Extending Adjuvant Endocrine Therapy: 3 Trials, Few Answers

SAN ANTONIO — Despite three new trials examining the extension of adjuvant endocrine therapy in hormone-positive breast cancer, there were no easy answers here at the San Antonio Breast Cancer Symposium (SABCS) 2016. The trials were the NASPB B-42, IDEAL, and DATA studies.
"I was anticipating a new milestone of knowledge... [but] whether we like it or not, essentially these three trials did not reach statistical significance to demonstrate clear benefit for their respective aromatase inhibitor extensions," commented Michael Gnant, MD, from the Medical University of Vienna, Austria.
In particular, the NASBP B-42 trial was much anticipated because it examined extending adjuvant therapy with the aromatase inhibitor (AI) letrozole (Femara, Novartis) for 5 years in patients who had initially received 5 years of adjuvant therapy with an AI (either alone or mixed sequentially with tamoxifen).
"The first extended adjuvant therapy trials (MA-17, NSABP-B33 and ABCSG-6a) investigated AIs after tamoxifen and demonstrated significant benefits for patients. However, those trials did not answer the question, should we also use extended AI treatment after AIs were used in initial adjuvant therapy? This is why NASBP B-42 is so important," said Dr Gnant.

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