Triptorelin With Exemestane – pro
The proposed treatment is in a clinical study: Triptorelin With Either Exemestane or Tamoxifen in Treating Premenopausal Women With Hormone-Responsive Breast Cancer (TEXT), NCT00066703. However, some results were already published:
April 4, 2016 by the Journal of Clinical Oncology. Read the abstract of “Absolute Benefit of Adjuvant Endocrine Therapies for Premenopausal Women With Hormone Receptor-Positive, Human Epidermal Growth Factor Receptor 2-Negative Early Breast Cancer: TEXT and SOFT Trials.”
Both the TEXT and the SOFT studies included women who were randomly assigned to receive either:
•Aromasin plus Trelstar for 5 years
•tamoxifen plus Trelstar for 5 years
Women in the SOFT study who were still premenopausal after chemotherapy treated with Aromasin plus ovarian suppression who had the highest recurrence risk had a 10% to 15% improvement in BCFI compared to women treated with tamoxifen plus ovarian suppression or tamoxifen alone. Women with intermediate recurrence risk had at least a 5% improvement in BCFI.
Women in the SOFT study who didn’t receive chemotherapy had the lowest recurrence risk on average and did well no matter which hormonal therapy they received. So these women didn’t receive any extra benefit if they were treated with Aromasin plus ovarian suppression.
Women in the TEXT study who weren’t treated with chemotherapy and had a low risk of recurrence did well with either Aromasin plus ovarian suppression or tamoxifen plus ovarian suppression.
The results of this analysis are promising for women diagnosed with early-stage, hormone-receptor-positive, HER2-negative breast cancer with a high risk of recurrence and suggest that Aromasin plus ovarian suppression offers benefits for some of them.
The NCCN does nto include this therapy in tis gudelines and much more discussion of this complex results and a publication in a peer-reviewed journals, as well as other studies are needed to adopt this strategy on a routine basis.
Meredith M. Regan et al, Absolute Benefit of Adjuvant Endocrine Therapies for Premenopausal Women With Hormone ReceptorPositive, Human Epidermal Growth Factor Receptor 2Negative Early Breast Cancer: TEXT and SOFT Trials. of Clinical Oncology 34, no. 19 (July 2016) 2221-2231.
NCCN, Breast Cancer 2017