番茄社区

At the virtual San Antonio Breast Cancer Symposium, researchers presented 12-year results for tamoxifen versus anastrozole [Arimidex], which demonstrated no significant difference in terms of disease recurrence in postmenopausal women with hormone-receptor-positive ductal carcinoma in situ, or DCIS; but the two treatment approaches had different toxicity profiles.

In this exclusive 番茄社区 video, , of the Cleveland Clinic, outlines the results and what it means moving forward.

Following is a transcript of her remarks:

This study was previously published with about 7 years of follow-up, and at that time showed a non-inferiority of anastrozole to tamoxifen, but did not show an advantage to one treatment over the other.

On the other hand, the NSABP B-35 study, which looked at postmenopausal women with DCIS treated with breast-conserving surgery and radiation, did show a modest advantage to anastrozole over tamoxifen, which was particularly true for the younger postmenopausal women.

So at this meeting, the updated analysis of the IBIS-II trial included about 12 years of follow-up, and there continued to be no significant difference in the risk of recurrence, whether that's invasive recurrence or non-invasive recurrence. And there was also no difference related to breast cancer in the two arms of the study.

Interestingly, breast cancer-related death was very rare, with only seven out of close to 3,000 patients in this study dying from breast cancer.

So that kind of tells us that we really want to think about toxicity in choosing adjuvant endocrine therapy for this population. We did see differences in side effect profiles of the two medications with a higher risk for secondary cancers, including endometrial cancer, and higher risk for thrombosis with tamoxifen. Whereas we see more musculoskeletal symptoms and risk for fracture and hyperlipidemia with the aromatase inhibitors.

So I think the bottom line is that tamoxifen is a reasonable adjuvant treatment option for postmenopausal women with ductal carcinoma in situ. And the choice really should be guided by toxicity profiles rather than efficacy.

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