Ten years of letrozole improves survival and quality of life in early-diagnosed breast cancer
Dr Julie Lemieux - Hôpital du Saint-Sacrement, Québec, Canada
MA 17R was a trial mainly of continuing aromatase inhibitor for ten years versus stopping it after the first five years in women with hormone receptor positive breast cancer who are menopausal. Because these women were between five and ten years breast cancer survivor at randomisation and were going to have five years of therapy we wanted to look at patient reported outcomes to see how they were feeling during this period.
Could you tell us quickly about the effects of the ten year administration of the aromatase inhibitors and then how that was affecting patient outcomes after the five or ten year mark?
We saw in The New England Journal of Medicine paper that was published this morning by Dr Goss that there was a 4% benefit in disease free survival in favour of letrozole compared to placebo. Now in terms of quality of life, quality of life was evaluated by asking women to complete questionnaires yearly for five years. We used two questionnaires, one that looked more at general quality of life that is called SF-36 and a second one that looked more at the menopause specific quality of life called the MenQual. Over the five year period when we look at the global quality of life as measured by the two summary scores of the SF-36 questionnaire we saw that there was no difference between the letrozole and the placebo arm. There was no difference either in the menopause specific quality of life, the only difference was seen in one of the SF-36 subscales and this difference was small and probably not clinically significant for the patient.
Could you just comment on the access to aromatase inhibitors - because they are so commonly available would it just be easy to incorporate into…?
Yes. Women are already used to taking their endocrine therapy and the results from MA 17R and the patient reported outcome result as well will give information for the patient and the physician to discuss together whether they’re going to continue for ten years or stop after five years.