For example,
Should it extend it beyond:
A vast international meta-analysis on more than 22. Consequently, 000 patients assessed the benefit-risk ratio of an anti-abomatase treatment in menopausal women carrying early breast cancer expressing hormonal receptors (HR+).
Hormone therapy reduces the risk of recurrence in menopausal women carrying early breast cancer expressing hormonal receptors (HR+). Nevertheless, The gain is around 40 % at 10 years after five years of treatment by tamoxifen (T). Moreover, 50 % at 10 years after five years of treatment with anti-abomatases (AA) (1-2). Consequently, Cancer mortality is also reduced, by 30 % for T and 40 % for AA. Therefore, Of course the risk persists after 5 years. Moreover, If the extension of hormone therapy beyond 5 years decreases the risk. Moreover, it increases toxicity (endometrial cancer, thromboembolic events) and estrogenic deprivation (heat puffs, muscle pain, osteoporosis, fracture risk) (3) and the benefit on mortality is should it extend it beyond not clearly asserted. For example, A meta-analysis published in the Lancet allows you to answer certain questions (4). However,
The results of 12 studies (carried out between December 1995 and May 2014) were compiled, approving data of 22,031 patients. The objective was to compare the benefit of prolonged hormone therapy (HP) by AA (2–3 years. 5 years) to the lack of additional treatment, after ≥ 5 years of hormone therapy (by T alone, T + AA, or AA alone). The main criteria were the recurrence rates (local, remotely, contralateral) and specific and global mortality. The results were analyzed as intention to deal with.
AA hormone therapy reduces recurrences by 27 %
The median age was 63 years (IIQ 56–69), and 10,038 (45.6 %) of the 22,031 patients had a lymph node extension. Additionally, The HER2 status was known for 7,676 (34.8 %) of 22,031 tumors, with 857 (11.2 %) HER2 +tumors. The should it extend it beyond AA tested were the letrozole (6 tests), the anastrozole (4 trials) and the exemmetane (2 trials). Overall, HP by AA reduced recurrences by 27 % (RR = 0.73; 95 % CI 0.67–0.80; p <0.0001). The effect was even more marked after t only (RR initial 0.56, p <0.0001). but it was limited by a high percentage of crossover In two major trials, which prevents long -term mortality from the mortality. In patients who have already received an AA, an additional 5 years of AA led: a reduction in recurrences: 11.6 % vs 15.2 % at 10 years (RR = 0.71), a remote metastase reduction: 6.6 % vs 8.6 % (RR = 0.73) and a non -significant reduction in mortality by breast cancer: 4.4 % vs 5,0 % (RR = 0,90).
Absolute benefit is significant in the event of a lymph node extension
For the HP after AA. the analysis by subgroups should it extend it beyond did not show any difference depending on age, lymph node status, size or tumor grade, HER2/PR status or AA molecule. On the other hand. absolute benefit regardless of initial hormone therapy was significant in the event of a lymph node extension (4 lymph nodes and more). The risk of endometrial cancer remained low and not modified (p = 0.12) by the duration of hormone therapy. It was the same for the risk of death of cardiovascular origin (68 deaths vs 70) or not linked to cancer. On the other hand, there was an increase in the risk of fracture (4.6 % vs 3.4 % (RR = 1.35; p = 0.0009), heat puffs, muscle pain but not hypercholesterolemia, high blood pressure, or thrombo-ebone events. Overall, the non-observance rate was high (≈ 39 %) but only two studies compared an HP to a placebo, therefore limiting the conclusions.
In conclusion. prolonging a treatment should it extend it beyond by AA by 5 years reduced by approximately a quarter the risk of recurrence, especially from a distance, without excess of mortality not linked to cancer at the cost of an increased but moderate fracture risk. The effect on specific mortality remains uncertain, however, lack of power and fairly long monitoring. The extent of absolute profit depends on the residual risk (larger in the event of lymph node damage). life expectancy and compliance with treatment, a major subject to maximize profits.
should it extend it beyond — Should it extend it beyond: A vast international meta-analysis on more than 22. 000 patients assessed the benefit-risk ratio of an anti-abomatase treatment in menopausal women carrying early breast cancer expressing hormonal receptors (HR+).Hormone therapy reduces the risk of recu.
Further reading: No shortage scheduled for the moment, the ANSM announces – China signals 7000 cases of infection in the chikungunya virus – For the State, financialization goes well with ethics – AI is not without risk: a man involuntarily poisoned after asking for advice from Chatgpt – The genes of which parent are more important?.
