Interview
with Neil Love, MD from Breast Cancer Update for Medical Oncologists,
Program 5 2000
Play
Audio Below:
There
are several trials now that have either randomized patients to have
Zoladex added or compared. There’s a large European trial,
which has been presented by Lars Rutqvist at a previous ASCO meeting,
where patients who were in the adjuvant setting, premenopausal,
were randomized. They either got chemotherapy or didn’t get
chemotherapy. They could be randomized to Zoladex or no treatment.
They could also be randomized to tamoxifen or no treatment, but
some of them got tamoxifen just as the therapy of choice and were
randomized to Zoladex or not. And in that trial, Zoladex is showing
quite a bit of additional benefit, I think in both disease-free
and overall survival. The tamoxifen randomization, in turn, isn’t
showing quite as much benefit, but then there aren’t as many
patients who were randomized to tamoxifen or not, so its unclear
whether both are better than one alone but certainly the Zoladex
effect is quite striking. Also, Nancy Davidson has presented work
in which all premenopausal patients got CAF chemotherapy. They were
then randomized to Zoladex or Zoladex plus tamoxifen, and again
the Zoladex has added quite considerably and the tamoxifen a bit
less, but there’s a bit less power. But it appears that the
Zoladex – she’s done an exploratory analysis in which
it appears that the Zoladex may do more in the younger patients
or the patients who don’t become amenorrheic from their chemotherapy,
and the tamoxifen may do more with the older patients or the patients
who’ve already become amenorrheic anyway. And that would suggest
that knocking out the ovaries is one piece of it and then adding
the tamoxifen is another separate piece.
Combined
endocrine therapy for breast cancer - New life for an old idea? Davidson, N. E. (Reprint available from: Davidson NE Johns Hopkins
Oncol Ctr 1650 Orleans St,Rm 409 Baltimore, MD 21231 USA). Journal
of the National Cancer Institute 92(11):859-860, 2000 Jun 7. No
abstract
