Hormone treatment could cut need for chemo in some younger breast cancer patients

Around 5,500 pre-menopausal breast cancer patients could be offered a hormone drug that is shown to be as effective as traditional chemotherapy – and so avoid potential infertility and long-term menopausal side effects – according to a Cancer Research UK report published today in The Lancet #.

Hormone therapy drugs which stop the ovaries from producing oestrogen is as effective as conventional chemotherapy for many pre-menopausal breast cancer patients with the added benefit of them being better tolerated by patients.

This means women, whose breast cancer is hormone sensitive,* may not need risk becoming permanently infertile or suffering the unpleasant side effects caused by chemotherapy.

The report showed that when pre-menopausal women were treated with a particular hormone therapy drug their chance of the disease recurring was no higher than having chemotherapy alone.

The drugs, called LHRH agonists**, stop the pituitary gland producing luteinising hormone, and so remove the stimulus for the ovaries to make oestrogen. But once the treatment stops the ovarian function usually returns to normal.

When younger breast cancer patients have chemotherapy the treatment accelerates the menopause and can deny women the chance to have children. In addition, many women suffer from long-term unpleasant post-menopausal side effects.

Professor Jack Cuzick, Cancer Research UK scientist and lead author of the study, said: “We analysed 16 trials involving LHRH agonists and these results point to an important additional approach to treating breast cancer.

“They mean that premenopausal women with hormone receptor positive low risk breast cancer could consider treatment that is as effective as chemotherapy without having to endure unpleasant side effects and risk losing their fertility. For all women aged under 40, this treatment can be added to chemotherapy to improve outcome further. In all cases tamoxifen, a different kind of hormone treatment, would also be usually be used as standard treatment.”

About two thirds of pre-menopausal patients have hormone sensitive breast cancer which equates to around 5,500 women being diagnosed in the UK every year.

Overall 42,000 women are diagnosed with breast cancer every year in the UK. Of these around 80 per cent are over the age of 50.

Kate Law, head of clinical trials at Cancer Research UK, said: “Breast cancer is always a shocking diagnosis but it is particularly sad when its treatment results in women being unable to have children.

“This is a very encouraging finding and suggests breast cancer treatment for some pre-menopausal women could be less devastating while being equally effective as conventional chemotherapy.”

Ends

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Notes to Editor

Jack Cuzick is the John Snow Professor of Epidemiology at the Wolfson Institute of Preventive Medicine, Queen Mary, University of London.

# Vol: 269; pages 1711-23

* Most breast cancers are hormone sensitive and are stimulated to grow by the female sex hormones oestrogen and progesterone. These breast cancers are called ‘hormone sensitive’ or ‘hormone receptor positive’ and can be treated with drugs that block the effects of these hormones.

**The hormone therapy drugs mimic the function of the natural luteinising-hormone-releasing hormone (LHRH) and are known as LHRH agonists.