Most are aware that a medication may affect individuals to a different degree. Now, a new UCLA study has reported that younger and older patients experience different symptoms from the same breast cancer drugs. The findings could help doctors and patients determine the most appropriate treatment options, and offer more personalized care for women with ductal carcinoma in situ (DCIS).
The study assessed the long-term outcomes in postmenopausal women who took two widely used breast cancer treatments and found that both drugs were safe and effective, and had no detrimental effect on overall quality of life. However, there were some differences in the type and severity of symptoms the women experienced with each treatment, and these particularly differed by age.
Study leader Patricia Ganz, MD, director of the UCLA Jonsson Comprehensive Cancer Center’s Prevention and Control Research program and her colleagues reviewed data from 1,193 patients enrolled in a phase 3 clinical trial in which the drugs anastrozole and tamoxifen were compared in postmenopausal women with DCIS who underwent lumpectomy plus radiotherapy. The women were evaluated in regard to the effect on their physical and emotional functioning (quality of life) and various symptoms such as hot flashes, vaginal dryness, as well as muscle and joint aches and pains. Patients older and younger than 60 years of age were analyzed in separate groups.
The investigators found that the pattern and severity of side effects of the two drugs differed. Women who took tamoxifen complained of more severe hot flashes, while anastrozole users reported greater severity of vaginal dryness and muscle/joint pains. Hot flashes, weight problems, vaginal symptoms and gynecological symptoms were worse in women younger than 60 years than those 60 years or older. The study also revealed that symptoms such as depression and fatigue were no different in comparison between the two drugs and did not increase in patients during the five years of treatment.
Overall quality of life and symptoms were assessed at the beginning of the study prior to randomization to the drugs, during the five years of treatment, and 12 months after treatment. The phase 3 clinical trial, from which the UCLA researchers extracted the data for their study, was conducted to determine whether anastrozole was superior to tamoxifen. Dr. Ganz also is a co-author of that research, which also was published December 10th by The Lancet. She explained, “Both of these drugs are excellent and can reduce the risk for breast cancer recurrence in postmenopausal women with DCIS that is hormone receptor positive. Physicians and patients need to use this information along with the main trial outcomes to choose the optimal treatment for each woman. This is part of personalized or precision medicine.”