Ovarian suppression imporves 8-year breast cancer survival
The addition of ovarian suppression
to tamoxifen lengthened overall survival (OS) and disease-free survival (DFS)
among premenopausal women with breast cancer, according to updated findings
from the TEXT and SOFT trials published in The New England Journal of
Medicine.
Results — which were published in
correspondence with a presentation at the ASCO Annual Meeting on freedom from
distant metastases data from the trials — also showed exemestane plus ovarian
suppression resulted in higher rates of freedom from recurrence.
The researchers performed a
prespecified updated analysis of the SOFT and TEXT trials. In the SOFT trial,
researchers randomly assigned women to receive tamoxifen alone (n = 1,021),
tamoxifen plus ovarian suppression (n = 1,024), or exemestane plus ovarian
suppression (n = 1,021). In the TEXT trial, researchers randomly assigned
patients to tamoxifen (n = 1,334) or exemestane (n = 1,338), both with ovarian
suppression. In both studies, women received treatment for 5 years.
Eight-year OS was 93.3% with
tamoxifen plus ovarian suppression group compared with 91.5% in the tamoxifen
group (HR = 0.67; 95% CI, 0.48 to 0.92). The difference with exemestane plus
ovarian suppression compared with tamoxifen alone did not reach statistical
significance (92.1%; HR = 0.85; 95% CI, 0.62-1.15).
Among women who remained
premenopausal after chemotherapy, 8-year OS was 89.4% with tamoxifen plus
ovarian suppression compared with 85.1% with tamoxifen alone (HR = 0.59; 95%
CI, 0.42 to 0.84). For exemestane plus ovarian suppression, 8-year OS was 87.2%
(HR vs. tamoxifen alone = 0.79; 95% CI, 0.57-1.09).
Among women with HER-2-negative
disease who underwent chemotherapy, 8-year OS was 85.2% among patients assigned
tamoxifen alone, 87.7% among those assigned tamoxifen plus ovarian suppression
(HR vs. tamoxifen = 0.7; 95% CI, 0.48-1.02), and 88.7% among those assigned
exemestane plus ovarian suppression (HR vs. tamoxifen = 0.71; 95% CI,
0.49-1.05).
The 8-year rate of freedom from
distant recurrence was 91.8% for exemestane plus ovarian suppression and 89.7%
for tamoxifen plus ovarian suppression (HR = 0.8; 95% CI, 0.66-0.96).
“Longer follow-up is planned for SOFT and
TEXT, data regarding survival to confirm the findings"
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