Study: More Women Can Cut Cancer Relapse Risk

[Guest guest]

By Rob Stein

Washington Post Staff Writer

Tuesday, March 11, 2008; Page A12

Women who survive breast cancer are often haunted by the fear that it might

come back. But new research indicates that many more women than had been

thought can do something to protect themselves.

Currently, women whose tumors were fueled by the hormone estrogen can take

the drug tamoxifen after undergoing surgery, radiation and chemotherapy to

reduce their risk of a recurrence. But tamoxifen only helps for five years.

After that, it may be dangerous.

Five years ago, researchers stopped a large international study early when

it showed that women who had early-stage breast cancer and who took another

drug, known as an aromatase inhibitor, after tamoxifen were nearly half as

likely to suffer a relapse. But many questions remained, including whether

it would work for women who had been diagnosed years ago.

In the new research, E. Goss of Massachusetts General Hospital and his

colleagues looked at more than 1,500 women who had been taking a placebo in

the original study but then started taking the aromatase inhibitor letrozole

after the study was stopped. It had been at least a year and as many as

seven years since they had stopped taking tamoxifen.

Even so, compared with the risk to about 800 women who did not start taking

letrozole, the risk of a recurrence was cut by 63 percent. In addition, the

risk of the cancer spreading was cut 61 percent, and the chance that a new

tumor would be found in the other breast dropped more than 80 percent.

A second paper, also published online yesterday by the Journal of Clinical

Oncology, answered another crucial question. Hyman Muss of the University of

Vermont did further analysis of the original study and found that letrozole,

which is sold under the brand name Femara, was effective in cutting the

recurrence risk for women of all ages, including those older than 70.

A third study, involving 1,598 patients, found that a different aromatase

inhibitor, known as exemestane or by the brand name Aromasin, was equally

effective at reducing the recurrence risk.

Together, the research indicates a need for a " paradigm shift " in treating

breast cancer survivors, U. Lin and P. Winer of the Dana-Farber

Cancer Institute wrote in an editorial accompanying the new research.