美時藥訊-荷爾蒙受體陽性的停經前乳癌患者 Exemestane plus OFS

  整合分析兩個大型國際性第三期臨床試驗，TEXT 和 SOFT，證實了荷爾蒙受體陽性的停經前乳癌患者進行人工停經後(ovarian function suppression, OFS)，使用Exemestane 進行術後輔助治療相較於Tamoxifen，更能避免乳癌的復發1, 2, 3, 4。
    這個研究的結果顯示，相較於Tamoxifen plus OFS，Exemestane plus OFS能降低術後疾病進展(Subsequent invasive cancer) 相關風險達28%，且降低乳癌復發(Breast cancer recurrence)風險達34%。
    過去幾十年來，Tamoxifen一直是荷爾蒙受體陽性的年輕停經前乳癌患者術後預防乳癌復發的標準治療。而最近的研究顯示Exemestane plus OFS療法將是一個可行的替代方案，且效果更好。但長期的存活率與安全性分析將有待更進一步的評估。

Note:
1. SOFT (suppression of ovarian function trial) / TEXT (tamoxifen and exemestane trial)
2. Ovarian function suppression, OFS: 打停經針、卵巢切除或是卵巢放射治療

參考文獻

1. NCT00066703 Triptorelin With Either Exemestane or Tamoxifen in Treating Premenopausal Women With Hormone-Responsive Breast Cancer (TEXT)

2. NCT00066690 Suppression of Ovarian Function Plus Either Tamoxifen or Exemestane Compared With Tamoxifen Alone in Treating Premenopausal Women With Hormone-Responsive Breast Cancer (SOFT)

3. Pagani O et al. Randomized comparison of adjuvant aromatase inhibitor (AI) exemestane (E) plus ovarian function suppression (OFS) vs tamoxifen (T) plus OFS in premenopausal women with hormone receptor-positive (HR+) early breast cancer (BC): Joint analysis of IBCSG TEXT and SOFT trials. 2014 ASCO Annual Meeting. 

4. Pagani O et al. Adjuvant Exemestane with Ovarian Suppression in Premenopausal Breast Cancer. N Engl J Med. 2014 Jun 1.