Breast Cancer Trials: How Hav... Video Transcript

Participants

, Maura N. Dickler MD, Generosa Grana MD, Linda T. Vahdat MD, Gabrielle Morris MD

Summary

There are now a wide variety of treatment options for breast cancer. How do you make sense of them all? Learn what experts have to say about the newest research and how it can affect you.

Webcast Transcript

ANNOUNCER: Today, there is a wide variety of treatments for breast cancer. Recently, new clinical research has surfaced around several drugs, all with different mechanisms of action, giving women with breast cancer many new options. One of the most studied categories is known as hormonal therapy.

LINDA VAHDAT, MD: There are many different kinds of hormonal treatments that we can use. One of them is something called SERMs, and this is just an acronym for selective estrogen receptor modulators. Another class of drugs that are used to treat breast cancer is called the aromatase inhibitors. The third family of drugs is the estrogen receptor downregulators.

ANNOUNCER: The goal of all of these hormonal treatments is to inhibit the effect of estrogen on breast cancer cells.

MAURA DICKLER, MD: They work by interfering with estrogen's ability to stimulate the growth of breast cancer. About two-thirds of breast cancer express estrogen receptors and we think estrogen is very important to stimulate the growth of those cancers. Drugs like tamoxifen and the aromatase inhibitors interfere with estrogen and starve the tumor cells of estrogen and therefore inhibit growth.

ANNOUNCER: Tamoxifen has long been considered the "gold standard" for breast cancer treatment. First as initial therapy for women with metastatic disease, or breast cancer that's spread from the breast to other parts of the body. Then later in early-stage breast cancer as adjuvant therapy, or treatment given after surgery to keep the cancer from coming back. But recent clinical trials have produced promising new data on the use of aromatase inhibitors in the adjuvant setting.

MAURA DICKLER, MD: The ATAC trial showed that women who took Arimidex had a lower risk of developing a recurrence of the breast cancer. The Arimidex appeared to delay the recurrence more than the tamoxifen. A recent update of the ATAC trial showed that the initial result has withstood the test of time and Arimidex is better than tamoxifen at reducing the risk of recurrence.

ANNOUNCER: Studies evaluating the use of Femara versus tamoxifen and Aromasin vs. tamoxifen in the adjuvant setting have also recently concluded.

MAURA DICKLER, MD: In all of the studies that looked at the aromatase inhibitors, there was an improvement at reducing the risk of recurrence in all women that either took the aromatase inhibitors right after surgery or switched from tamoxifen to the aromatase inhibitors, or who took the aromatase inhibitors after completing five years of tamoxifen.

ANNOUNCER: Although current data favors incorporating the aromatase inhibitors into a woman's adjuvant therapy, there are still many questions regarding when in the treatment process aromatase inhibitors should be used and for how long they are effective.

MAURA DICKLER, MD: It's still controversial as to whether the aromatase inhibitors should be used immediately after surgery, sequenced after two to three years of tamoxifen, or after five years of tamoxifen. And that decision should be made with the patient and her physician.

ANNOUNCER: Similarly, another hormonal drug whose use is evolving is Faslodex.

MAURA DICKLER, MD: Faslodex is an estrogen receptor downregulator. What that means is Faslodex binds to the estrogen receptor and causes its degradation. Basically it destroys the estrogen receptor. That's very useful for women who have hormone receptor-positive breast cancer. Faslodex has been shown to be as good as the aromatase inhibitors for the treatment of metastatic breast cancer, once a woman's cancer has grown on tamoxifen.