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Review
. 2017 Nov;9(11):679-692.
doi: 10.1177/1758834017732966. Epub 2017 Oct 27.

Optimal duration of adjuvant endocrine therapy: how to apply the newest data

Kerstin Wimmer  1 , Stephanie Strobl  1 , Michael Bolliger  1 , Yelena Devyatko  1 , Belgin Korkmaz  1 , Ruth Exner  1 , Florian Fitzal  1 , Michael Gnant  2
Affiliations
Review

Optimal duration of adjuvant endocrine therapy: how to apply the newest data

Kerstin Wimmer et al. Ther Adv Med Oncol. 2017 Nov.

Abstract

Background: The benefit of 5 years of adjuvant endocrine therapy for women with hormone receptor-positive (HR+) breast cancer (BC) is beyond discussion. Nevertheless, the risk of recurrence of luminal BC persists for 15 years or more after diagnosis. Consequently, approaches of extended adjuvant therapy have been investigated in large clinical trials, with the ultimate aim of further reducing the risk of recurrence in patients with HR+ BC.

Methods: A review of recently published trial data is presented to provide a solid basis for discussion. A discussion of the side effects of long-term endocrine treatment, multigenetic tests aiming to identify patients at particular risk, and an outlook for further promising targets are additional aims of this review.

Conclusion: Extended adjuvant therapy seems beneficial in reducing distant relapse and contralateral BC for a selected group of patients with HR+ BC, particularly if aromatase inhibitors (AIs) are used after initial tamoxifen therapy. However, patients with lower risk of recurrence and initial AI therapy may suffer more from side effects than benefit from extended therapy.

Keywords: adjuvant therapy; early breast cancer; extended adjuvant therapy; hormone receptor-positive breast cancer; postmenopausal.

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Conflict of interest statement

Conflict of interest statement: K.W., M.B., Y.D. and B.K. are not aware of any affiliations, memberships, funding, or financial holdings that might be perceived as affecting the objectivity of this review. R.E. has received travel and accommodation expenses reimbursement from Roche. S.S. has received personal fees from AstraZeneca, and travel or accommodation expenses reimbursement from Roche. F.F. has received travel or accommodation expenses reimbursement from Roche. M.G. has received institutional grants from Sanofi-Aventis, Novartis, Roche, GlaxoSmithKline, Pfizer, and Smith Medical, and personal fees from Novartis, Roche, GlaxoSmithKline, AstraZeneca, Nanostring Technologies, and Accelsiors, all outside this work.

Figures

Figure 1.
Figure 1.
Study designs of MA.17R, NSABP-B42, DATA, IDEAL, SOLE and SALSA (ABCSG 16) trials. AI, aromatase inhibitor; ET, endocrine therapy; Let, Letrozole; TAM, tamoxifen; R, randomization.
See this image and copyright information in PMC

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