Symptoms Of Toxicity Are Markers Of Breast Cancer Treatment Success

An article published early online and in the December edition of The Lancet
Oncology reports that if breast cancer patients who receive endocrine treatment
develop hot flushes, vasomotor symptoms (such as cold and night sweats), and
joint symptoms, then they have a lower likelihood of cancer recurrence. That
is, the toxicity of the treatment is acting as an indicator of treatment
success.



Professor Jack Cuzick (Cancer Research UK and Queen Mary School of Medicine and
Dentistry, London, UK) and colleagues say that the above
symptoms during endocrine treatment are related to estrogen depletion or
estrogen blockage.



Their analysis used data on women who participated in the Arimidex,
Tamoxifen, Alone or in Combination (ATAC) trial, a study designed to assess
tamoxifen or anastrozole for adjuvant therapy of post-menopausal breast cancer.
To test for a relationship between the toxicity symptoms and cancer recurrence,
the researchers compared two groups of women with hormone-receptor-positive
tumors: one group reported symptoms at their first follow-up visit in the ATAC
trial, and the second group did not report symptoms.



After three months of treatment, 37.5% of eligible women reported new vasomotor
symptoms. These women had a 9-year cancer recurrence rate of 23%, while women
without new vasomotor symptoms had a recurrence rate of 18%. The 31.4% of women
who reported new joint symptoms after three months of treatment had a 9-year
cancer recurrence rate of 14%, while those without joint symptoms had a 23%
recurrence rate. Women who received both tamoxifen and anastrozole exhibited
these rate differences, and anastrozole was linked to lower recurrence rates
than tamoxifen independent of the presence of symptoms.



"The appearance of new vasomotor symptoms or joint symptoms within the
first 3 months is a useful biomarker, suggesting a greater response to
endocrine treatment compared with women without these symptoms. Awareness of
the relation between early treatment-emergent symptoms and beneficial response
to therapy might be useful when reassuring patients who present with them, and
might help to improve long-term treatment adherence when symptoms cannot be
alleviated," conclude the authors.



Treatment-emergent endocrine symptoms and the risk of breast cancer recurrence:
a retrospective analysis of the ATAC trial

Jack Cuzick, Ivana Sestak, David Cella, Lesley Fallowfield, on behalf of
the ATAC Trialists' Group

The Lancet Oncology (2008).

DOI:10.1016/S1470-2045(08)70259-6

Click Here to View Journal Website



: Peter M Crosta


View drug information on Arimidex.