Concurrent use of tamoxifen with a direct oral anticoagulant is not associated with an increased risk for major hemorrhage compared with concurrent use of aromatase inhibitors in people with breast cancer, research suggests.

A database analysis has revealed poor adherence to adjuvant tamoxifen in older men with early-stage breast cancer.

Ivana Sestak puts the long-term results of the IBIS-II trial in the context of the NSABP B-35 study, both of which compared anastrozole with tamoxifen for breast cancer prevention in postmenopausal women with HR-positive ductal carcinoma in situ.

Long-term results from the IBIS-II trial show a comparable risk for breast cancer recurrence with anastrozole and tamoxifen among postmenopausal women with hormone receptor-positive ductal carcinoma in situ.

Serum analysis suggests that within a year of beginning endocrine therapy after early breast cancer treatment, around one in six premenopausal women are no longer adherent to tamoxifen.

Barbara Pistilli discusses the CANTO COMPLETE study of premenopausal breast cancer patient adherence to endocrine therapy (4:31).

Some symptoms experienced during preventive tamoxifen therapy and attributed to the medication could be age-related menopausal changes, say researchers who found an association between experiencing such symptoms early during treatment and reduced long-term adherence.

Participants either did or did not receive abemaciclib 150 mg twice daily for up to 2 years alongside standard of care ET with an aromatase inhibitor or tamoxifen.

The double-blind trial included 131 women (median age 54.9 years) who were on a stable dose of adjuvant tamoxifen or an aromatase inhibitor and reported at least 50 moderate to severe vasomotor symptoms – hot flashes or night sweats – per week.

The study included 1912 patients with hormone receptor-positive breast cancer who were disease-free after 2–3 years of adjuvant tamoxifen.

They explain: “Because we did not observe increased risk of recurrence in VET-treated patients receiving tamoxifen, switching to tamoxifen after 2 to 3 years of an AI may be considered for women initiating VET.”

Just over half (54.5%) of the patients had received adjuvant ET, most commonly tamoxifen, while the remaining 45.5% had not.

They had received breast-conserving surgery that achieved margins of at least 1 mm and sentinel lymph node biopsy, as well as endocrine therapy, consisting of 5 years or more of treatment with an aromatase inhibitor or tamoxifen.

Analysis showed that patients given aromatase inhibitors were significantly more likely to respond than those given tamoxifen (78.1 vs 41.1%), and that ET response was significantly more common in patients with an RS 0–11 than their counterparts with an RS of 12–25 or greater than 25 (78.8 vs 62.2 and 32.7%, respectively).

Endocrine therapy was indicated in 1375 women and initiated in 67%, most commonly with tamoxifen (91%), but just 40% continued treatment for at least 3 years.

Aromatase inhibitors significantly reduce the risk for breast cancer recurrence relative to tamoxifen in premenopausal women treated with ovarian function suppression, suggests a patient-level meta-analysis.

Extending adjuvant aromatase inhibitor therapy with letrozole to 5 years improves survival among women with hormone receptor-positive breast cancer who have already received 2 to 3 years of tamoxifen, shows the phase 3 GIM4 trial.

The only PROs significantly associated with early discontinuation of tamoxifen were baseline pain interference, hot flashes, and unhappiness, while hot flashes were associated with anastrozole discontinuation.

As per the prescribing information , abemaciclib should be given at a starting dose of 150 mg twice daily in combination with tamoxifen or an aromatase inhibitor for up to 2 years. medwireNews is an independent medical news service provided by Springer Healthcare Ltd. © 2021 Springer Healthcare Ltd, part of the Springer Nature Group