Saturday, December 13, 2008

Newer breast cancer drug cuts risk of death by a fifth compared to NHS treatment, research shows

A drug for breast cancer has been found to cut the risk of dying by almost a fifth compared with the Health Service's standard treatment. The research by an international team is the first to show that women with early breast cancer taking the aromatase inhibitor (AI) Femara for five years after surgery live longer without the disease, compared with those taking tamoxifen.

AIs were approved two years ago for NHS use in postmenopausal women after studies showed they cut disease recurrence and improve survival. But patients usually take tamoxifen initially and switch to an AI drug within two to three years. The study said women using the AI drug Femara, also known as letrozole, for the entire five-year period are more likely to survive.

Risk of death was reduced by 19 per cent, according to data presented to the San Antonio Breast Cancer Symposium in the U.S. by the International Breast Cancer Study Group. The trial studied 8,000 women in 27 countries, including the UK, of whom 5,000 were assigned to either Femara or tamoxifen without being switched. For the rest, who were switched to Femara halfway through, the survival benefit was 13 per cent.

Nigel Bundred, Professor of Surgical Oncology at South Manchester University Hospitals Trust, said: 'These data represent an important milestone in the treatment of women with breast cancer. 'For the first time we are seeing suggested survival benefit with upfront aromatase inhibitor letrozole therapy for five years compared with tamoxifen for the same time period.'

Henning-T Mouridsen, professor of oncology-at Copenhagen University Hospital-and one of the trial investigators, said the drug produces an 'early and sustained reduction' in recurrence of disease in the breast and its spread into the body. Around 44,000 British women develop breast cancer a year including 33,000 after the menopause.

AI drugs shut down the body's supply of oestrogen altogether, while tamoxifen works by blocking oestrogen's effects on cancer cells. These drugs work in women only after the menopause and where breast cells are sensitive to oestrogen - up to four in five cases.

The Government's rationing watchdog has approved three aromatase inhibitors (AI) - Aromasin, Arimidex and Femara - alongside tamoxifen. Primary care trusts are expected to fund them, but the annual cost of an AI is 900 pounds, compared with less than 300 for tamoxifen. A survey last year found only a fifth of Britain's biggest breast cancer hospital units were definitely following guidance to switch patients after initial treatment with tamoxifen.

Professor Jeffrey Tobias, Professor of Cancer Medicine at University College and Middlesex School of Medicine, said the latest findings mean AI drugs should now be used in preference to tamoxifen. He added that osteoporosis sufferers may still be better off on tamoxifen as AIs cause bone problems, but tamoxifen has a fourfold higher risk of causing womb disorders


No comments: