THE ROLE OF OVARIAN SUPPRESSION IN THE TREATMENT OF EARLY-STAGE HORMONE-SENSITIVE BREAST CANCER

2018 ◽  
Vol 14 (2) ◽  
pp. 54-60
Author(s):  
I. A. Koroleva ◽  
M. V. Kopp
Keyword(s):  
Breast Cancer ◽  
Clinical Trials ◽  
Adjuvant Chemotherapy ◽  
Early Stage ◽  
Operable Breast Cancer ◽  
Ovarian Suppression ◽  
Menstrual Function ◽  
Hormone Sensitive

Ovarian suppression (OS) is an effective method of treating hormone sensitive breast cancer. The combination of OS and tamoxifen in breast cancer is more effective than any of these methods used as monotherapy. A number of clinical trials confirmed the need for OS chemotherapy in patients with hormone-positive operable breast cancer, because women retained their menstrual function for 5 years. OS chemotherapy during adjuvant chemotherapy allows preserving fertility in patients with breast cancer.

Who benefits from taxanes?

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e11503-e11503
Author(s):  
M. J. Piccart-Gebhart ◽  
P. L. Bedard
Keyword(s):  
Breast Cancer ◽  
Clinical Trials ◽  
Intracellular Signaling ◽  
Early Stage ◽  
Research Effort ◽  
Receptor Expression ◽  
Molecular Heterogeneity ◽  
Early Stage Disease ◽  
Her 2

e11503 Over the last fifteen years, 21 clinical trials randomized nearly 36,000 women with early-stage breast cancer to taxane-based versus non-taxane-based adjuvant chemotherapy regimens to establish the role of taxanes in early breast cancer therapy. Preliminary results from the Oxford Overview –pooling individual patient data from some of these studies –suggest that the inclusion of a taxane to an anthracycline-based regimen reduces 10-year breast cancer related mortality by an absolute value of 5% over anthracycline therapy alone. In spite of this enormous global research effort, there remains considerable uncertainty regarding which patients benefit from taxane therapy. Three recent meta-analyses indicate that taxanes are beneficial irrespective of age, lymph node involvement, and hormonal receptor expression. Unfortunately, differences in trial design, pathological evaluation, and outcome reporting limit the robustness of these findings. Individual studies have suggested that patients with HER-2 positive disease derive greater benefit from taxane therapy, although the methods used to assess HER-2 status have been heterogeneous and there is no clear biological rationale to account for differential benefit in this subset. A number of promising predictive molecular markers related to taxane metabolism, microtubule dynamics, and intracellular signaling warrant further evaluation using biospecimens collected from the first-generation taxane trials. Future clinical trials should account for the molecular heterogeneity of breast cancer, by excluding the chemotherapy insensitive luminal A subset and mandating upfront central pathological assessment to further optimize the role of taxane therapy in early-stage disease. No significant financial relationships to disclose.

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