Interview
with Neil Love, MD from Breast Cancer Update for Medical Oncologists,
Program 5 2000
Play
Audio Below:
The
overview data is old and from old studies, which is good and bad,
and the number of patients in the ovarian ablation randomized trials
are few, compared to the number of patients in tamoxifen trials
or chemotherapy trials. So, were several thousand patients, in the
60s, 70s, that were randomized to ovarian ablation or not, at first
– mainly in the absence of any chemotherapy – and then
in some of the later trials, chemotherapy plus ovarian ablation
versus the same chemotherapy alone. And in fact, there’s very
clear data that ovarian ablation is beneficial used alone compared
to no treatment, no systemic treatment. It’s beneficial, it’s
beneficial with a sort of 30% improvement, much like what you saw
with all of the chemotherapies of that day: CMF, AC and so on. And
because the studies are so old, the patients weren’t really
selected on the basis of receptor status; the receptor status wasn’t
known in many of them. Then, as you get into a bit of the later
studies, you can see that added to chemotherapy, ovarian ablation
isn’t quite as clearly significantly effective, although it
tends to add something to chemotherapy. There either aren’t
enough patients or the effect is a bit smaller and you need more
patients to see it. So that it may be that with chemotherapy –
because you already affect some endocrine changes and you make some
of these patients amenorrheic or give them a chemical ablation –
that adding ovarian ablation doesn’t do as much.
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
