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Tamoxifen Therapy Plus Ovarian Suppression Improves DFS in HR-Positive Breast Cancer
Findings from a phase 3 study show that adding 2 years of ovarian suppression to tamoxifen therapy for patients with hormone receptor (HR)-positive breast cancer increased survival rates (J Clin Oncol. 2019 Sep 16. Epub ahead of print).
Previously, adding ovarian function suppression to tamoxifen postchemotherapy was found to have a positive impact on disease-free survival (DFS) in premenopausal patients with breast cancer.
Thus, Hyun-Ah Kim, MD, PhD, and colleagues sought to expand upon these data by evaluating the efficacy of adding 2 years of ovarian function suppression to tamoxifen therapy in patients with HR-positive breast cancer who are premenopausal or resume ovarian function after chemotherapy.
Out of 1483 patients with estrogen receptor-positive breast cancer aged ≤45 years who had undergone surgery after neoadjuvant or adjuvant chemotherapy, 1293 patients with premenopausal ovarian function randomized to receive 5 years of tamoxifen therapy with or without 2 years of ovarian function suppression. The primary end point of the study was DFS.
Ultimately, 1282 patients were deemed eligible for analysis by Dr Kim et al. Among these patients, the estimated 5-year DFS was 91.1% in the tamoxifen plus ovarian suppression arm versus 87.5% in the tamoxifen-only arm (hazard ratio [HR], 0.69; 95% CI, 0.48-0.97; P = .033). The estimated 5-year OS rates were 99.4% and 97.8%, respectively (HR, 0.31; 95% CI, 0.10-0.94; P = .029).
Adding 2 years of ovarian suppression to tamoxifen therapy significantly improved DFS rates among patients who remained premenopausal or resumed ovarian function postchemotherapy versus tamoxifen alone, Dr Kim and colleagues concluded.—Kaitlyn Manasterski
