Source: Journal of Clinical Oncology, March 21, 2011
A 10 year follow-up of women aged 50 and over with early breast cancer whose chemotherapy included Tamoxifen has been published in the Journal of Clinical Oncology. The study by researchers at Cancer Research UK touts the benefits of 5 years of Tamoxifen therapy.
Tamoxifen or NOLVADEX® (tamoxifen citrate) is Astra Zeneca’s nonsteroidal antiestrogen used to treat women with ductal breast cancer which may be metastatic. Tamoxifen itself has come under fire for being associated with an increased risk in uterine cancer, stroke and blood clots. Another known side effect of Tamoxifen is peripheral neuropathy or nerve disorder of the legs which can make walking painful and difficult.
The Cancer Research UK “Over 50s” trial compared women with early breast cancer who were prescribed Tamoxifen for 5 and 2 years, respectively. Of the patient’s in the study between 1987 and 1997, 3,449 patients age 50 to 81 years with operable breast cancer who had been taking 20 mg of tamoxifen for 2 years were randomly assigned to either stop or continue for an additional 3 years, if they were both alive (duh!) and recurrence free.
After this 10 year study, the following data were reported: There were 1,103 recurrences of breast cancer. 755 women died of their breast cancer. 621 women suffered cardiovascular events (ie. stroke). Of those, 236 women died.
For every 100 women who received tamoxifen for 5 years, there were 5.8 fewer recurrences, compared with those who received tamoxifen for 2 years. The risk of contralateral (in the opposite) breast cancer was significantly reduced (hazard ratio, 0.70; 95% CI, 0.48 to 1.00). Among women age 50 to 59 years, there was a 35% reduction in cardiovascular events and a 59% reduction in death as a result of a cardiovascular event. In older women, the effect was much smaller and not statistically significant.
The study concludes that taking tamoxifen for the recommended 5 years reduces the risk of recurrence or contralateral breast cancer 15 years after starting treatment. It also lowers the risk of cardiovascular disease and death as a result of a cardiovascular event, particularly among those age 50 to 59 years. The recommendations of the researchers are that women should, “Be encouraged to complete the full course.”
Post: David M. Schwadron, Esquire