UK begins using drug to prevent breast cancer in postmenopausal women
The hormonal drug anastrozole is one of the therapeutic options commonly used for breast cancer in postmenopausal women.. Now, the Medicines and Healthcare products Regulatory Agency (MHRA) in the United Kingdom also allows its use to prevent this tumor in women at risk.
The indication is extended to postmenopausal women with moderate or high risk of developing the disease, who could number around 289,000 in the United Kingdom, according to estimates from the British National Health Service (NHS).
“This is the first medicine to be repurposed through a new world-leading program to help us harness the full potential of existing medicines into new uses to save and improve more lives in the NHS.. Through this initiative, we hope that greater access to anastrozole will allow more women to take steps to reduce their risk if they wish, helping them live without fear of breast cancer,” said Amanda Pritchard, chief executive of the NHS, in a statement.. “It's fantastic that this vital risk-reducing option can now help thousands of women and their families avoid the heartbreak of a breast cancer diagnosis.”
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Prophylactic treatment consists of one 1 mg tablet, once a day for 5 years.. Anastrozole is an aromatase inhibitor, which, by blocking that enzyme, reduces the amount of estrogen produced by the body.
Are there side effects after taking the drug?
The most common side effects of the medication are hot flashes, feeling weak, joint pain or stiffness, arthritis, rash, nausea, headache, osteoporosis, and depression.
The decision to use the drug as a preventive treatment, according to the MHRA, is based on the evidence provided by the IBIS-II study, an international, randomized, double-blind, placebo-controlled trial, which showed that women receiving anastrazole developed fewer breast tumors than those in the placebo group.
Judith Balmaña, medical oncologist from Vall d'Hebron, head of the VHIO Hereditary Cancer Genetics Group and member of the SOLTI cancer research group, values the measure adopted in this medium because “it involves caring for people from a health perspective, in health, to reduce your risk of developing a disease.
The specialist points out that this is progressing along a path in which little by little “we make increasingly personalized risk estimates, for which risk-reducing measures can then be provided, whether pharmacological or not.”. Although the oncologist is in favor of starting with non-pharmacological ones, since you always have to weigh the side effects of the medications.
What is the impact of this drug?
However, it stands out that anastrozole – which, together with tamoxifen, has this indication in the United Kingdom to prevent breast cancer – showed in a clinical study its effectiveness in reducing the probability of developing the tumor by half, a not trivial figure.. “From there it is interesting to start this conversation about the measures that allow health care to be carried out from health,” he reflects..
The IBIS-II study was published in 2019 in The Lancet, with Jack Cuzick of Queen Mary University of London as lead author.. The results then published were based on data from 3,864 study participants (1,920 received anastrazole for five years, and 1,944 received placebo).
The model to assign the level of risk of hormonal cancer in women took into account factors such as family history, breast density, obesity, alcohol consumption and a premalignant lesion, among others.
Follow-up extended over a period of 12 years, with a median of 10.9 years. At 12 years (seven after stopping treatment), the incidence of breast cancer was found to be 49% lower in those taking the drug than in women receiving a placebo.
What is drug adherence like?
Additionally, the researchers also reported that there were no significant long-term side effects in the years after stopping anastrozole treatment, particularly an increase in bone fractures or disease.
Adherence during the five years of taking the tablets was 77% in the placebo group and 74.6% in the anastrozole group. Suggesting that the side effects were not severe enough to deter taking the drug.