Responses
in Sequential Hormone Therapies for Breast Cancer
According to results presented at the 25th annual San Antonio
breast cancer symposium, patients with hormone-positive breast
cancer appear to respond to sequential hormone therapy, even
if they don?t respond to their initial type of hormone therapy.
Hormone-positive breast cancer is stimulated to grow when
exposed to estrogen and/or progesterone, female hormones that
circulate in the body. Hormone therapy reduces or prevents
the production of estrogen and/or progesterone in the body
or reduces the growth stimulatory effects these hormones impart
on the cell. At present, different types of hormone therapy
are available to patients with hormone-positive breast cancer.
Several clinical trials are ongoing to directly compare the
different types of hormone therapy in various stages of breast
cancer. However, many of these types of hormone therapies
are new in the clinical setting. Thus, the optimal sequencing
of hormone therapies has not yet been established, and may
be different for each individual based on disease characteristics.
Researchers from England conducted a clinical study to determine
whether 122 patients with advanced breast cancer who had already
been treated with initial hormonal therapy consisting of either
Nolvadex ® (tamoxifen) or Faslodex ® (fulvestrant) benefited
from subsequent hormone therapy. In this follow-up study,
patients were given questionnaires regarding their subsequent
hormone therapies and responses. In this study, clinical benefit
is defined as anti-cancer responses or disease stabilization
for a minimum of approximately 6 months.
Of the patients who achieved a clinical benefit from initial
hormone therapy with Faslodex ®, 57% achieved a clinical
benefit from subsequent hormone therapy with aromatase inhibitors,
Nolvadex ®, or megestrol acetate. Of the patients who achieved
a clinical benefit from initial therapy with Nolvadex ®,
61% achieved a clinical benefit from subsequent therapy including
aromatase inhibitors, megestrol acetate, and medroxyprogesterone
acetate.
Of the patients who did not respond to initial therapy with
Faslodex ®, approximately 43% still achieved a clinical
benefit from subsequent hormone therapy consisting of either
aromatase inhibitors, Nolvadex ®, megestrol acetate, or
medroxyprogesterone acetate. Of the patients who did not respond
to initial therapy with Nolvadex ®, 57% achieved a clinical
benefit from subsequent hormone therapy consisting of aromatase
inhibitors and megestrol acetate.
The Swiss Group for Clinical Cancer Research also conducted
a clinical trial to evaluate the effectiveness of Faslodex ®
in women with advanced breast cancer who had stopped responding
to or had never responded to both Nolvadex ® and an aromatase
inhibitor. Treatment with Faslodex ® resulted in a clinical
benefit in 34% of these women.
These results indicate that patients with breast cancer can
be successfully treated with sequential hormone therapies,
even if they did not respond to their prior hormone therapy.
Patients who have stopped responding to hormone therapy may
wish to speak with their physician about the risks and benefits
of treatment with subsequent hormone therapy or the participation
in a clinical trial further evaluating hormone therapy or
other novel therapeutic approaches. Two sources of information
regarding ongoing clinical trials include the National Cancer
Institute (cancer.gov) and www.eCancerTrials.com. ECancerTrials.com
also provides personalized clinical trial searches on behalf
of patients.
Reference: Carlson, R. Oncology Times. 2003;Special Edition
reporting on the 25th annual San Antonio breast cancer symposium:
10-11.
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