optimize hormone therapy at an early stage

optimize hormone therapy at an early stage

2023-06-05 11:18:38

It’s a gain that may seem modest, but it could save several hundred lives each year in France, if its promise is kept. Evidenced by the results of a clinical trial presented in Chicago, Friday, June 2, at the congress of the American Association of Clinical Oncology (ASCO). They show how the addition of a targeted therapy taken by mouth can optimize the hormone therapy used in certain early-stage breast cancers. In the treated group, a 25% reduction in the risk of relapse was indeed measured, with three years of follow-up.

The trial focused on so-called cancers « hormone-dependent” (RH+), the most common form of breast tumors (70% of all forms), the most frequent cancers in the world – more than 2.2 million new cases each year, of which 60 000 in France. More specifically, the researchers focused on HR+ cancers which do not present, on the surface of the tumor cells, excess “HER2 proteins” (receptors whose presence can lead to specific treatments).

In women with these cancers, the standard treatment is, after surgery, hormone therapy often combined with chemotherapy. In the ten to fifteen years following hormone treatment, between a third and half of patients will relapse, however, even when the cancer is diagnosed at an early stage – before it has spread outside the breast – in those with poorer prognostic criteria.

How to reduce this risk? Over the past ten years, a new family of drugs has appeared. Active orally, they act by inhibiting proteins called “CDK4” and “CDK6”, which control the rate of cell growth and division.

Gain « colossal »

Like any therapeutic innovation, these targeted therapies, or « anti-CDK4-6”, were first evaluated in cancers of advanced or metastatic stage. In affected women, “These drugs have revolutionized the prognosis”, explains Anthony Gonçalves, oncologist at the Paoli-Calmette Institute, in Marseille. The median overall survival has thus increased from fifty-one to sixty-four months, a gain considered « colossal ».

The next step was to assess their interest in still localized cancers. The essay presented in Chicago, called “Natalee”, met this objective. Conducted in 20 countries, it recruited 5,101 pre- or postmenopausal women and men with hormone-dependent breast cancer, diagnosed at an early stage but presenting an increased risk of recurrence.

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