Combination treatment may extend late-stage breast cancer survival

October 23, 2018

A recent trial proposes combining a specific drug with hormone therapy to extend the survival of some women with advanced breast cancer.

The study showed that women who received palbociclib and hormone therapy lived up to 10 months longer than those given hormone treatment alone.

It also delayed the time at which women needed to begin chemotherapy, which often has debilitating side-effects.

So far, the preliminary results of the trial have proven to be encouraging.However, the researchers have warned that it’s not a panacea and that the drug might not work on everybody.

The placebo-controlled clinical trial tested the benefit of adding palbociclib to the hormone therapy fulvestrant in a trial of 521 women with advanced, oestrogen-receptor positive breast cancer whose tumours did not have the HER2 gene. Oestrogen-receptor positive breast cancers are the most common form of breast cancer, accounting for about 70% of cases.

The study was led by researchers from the Institute of Cancer Research in London, and the Royal Marsden NHS Foundation Trust. They examined the effect of palbociclib on women’s overall survival and whether it could delay the need for chemotherapy.

The results showed that in women whose tumours had previously responded well to hormone therapy (410 of the 521 women), the treatment extended survival by 10 months to an average of 39.7 months, compared with 29.7 months in the women who received fulvestrant and a dummy pill (placebo).

The treatment has yet to extend survival in those who had previously not responded well to hormone therapy.

Three years after they were enrolled in the study, 49.6% of women who received both palbociclib and fulvestrant were still alive, compared with 40.8% of women who were treated with fulvestrant alone.

Those given the combination treatment also were also able to delay chemotherapy by nine months.

“The development of palbociclib is one of the biggest advances in treatment for women with advanced breast cancer in the last two decades,” said Professor Nicholas Turner, the study leader.

“This drug can offer women more precious time with their loved ones, and because it is a targeted treatment it is much kinder than chemotherapy, and enables many women to carry on with their lives normally.”

Palbociclib was approved for use in England by NICE in November 2017, but currently is only available for women with oestrogen receptor-positive breast cancer who were diagnosed after the disease had begun to spread.

The authors hope it will be made available to women whose breast cancer has previously been treated with hormone therapy.

Delyth Morgan, chief executive at Breast Cancer Now, said it was important for NICE to reform its method of appraising combination therapies so that breast cancer patients could benefit from the palbociclib and fulvestrant treatment.

 

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