Cancer Studies Show Improved Life Quality, FertilityNicole Ostrow
Two studies in women with breast tumors and a third in people with head-and-neck cancer have found ways to improve the quality of life of patients as they’re being treated for their disease.
One of the trials, reported yesterday at the American Society of Clinical Oncology annual meeting in Chicago, found that the hormone suppressor Zoladex from AstraZeneca Plc helped preserve fertility in breast cancer patients given chemotherapy. The other studies determined that patients with breast tumors and with head-and-neck cancer can take reduced doses of standard medications with the same outcome and lower side effects.
“Oncology isn’t just about helping people live longer,” Patricia Ganz, a director at the Jonsson Comprehensive Cancer Center at the University of California in Los Angeles, said in a statement. She wasn’t involved in any of the studies. “We need to ensure that patients have the best quality of life possible at every stage of their cancer journey.”
Breast cancer patients given Zoladex along with chemotherapy had a 64 percent lower chance of developing premature ovarian failure, compared with women who just underwent chemotherapy, that study found. They also had more successful pregnancies and higher survival rates.
The finding offers a new option for younger women in particular undergoing chemotherapy, said Halle Moore, the study author and an oncologist at the Cleveland Clinic in Ohio.
“This is the first demonstration that ovarian function is improved following this intervention,” Moore said in a telephone interview. “Survivorship has become increasingly important as we’ve become better at curing people of cancer.”
About 49,000 women under the age of 50 are diagnosed with invasive breast cancer each year in the U.S., and of those about 11,000 are under age 40. About 15 percent have hormone-receptor negative breast cancer, which means the disease doesn’t feed on hormones or respond to hormone therapy, according to the U.S. National Institutes of Health, which funded the research.
Chemotherapy is thought to cause infertility by damaging the ovaries while they are cycling. Zoladex and similar treatments, such as AbbVie Inc.’s Lupron, can temporarily shut down ovarian function and put patients into a post-menopausal state, Moore said. That acts as a protection, she said.
Researchers in the study looked at 218 women with early hormone receptor-negative breast cancer. Half received chemotherapy and Zoladex, a monthly injection, and the rest were given chemotherapy alone. Eight percent of women given Zoladex had ovarian failure two years after starting chemotherapy, compared with 22 percent in the chemotherapy only group. Twenty-two women on Zoladex became pregnant compared with 12 in the other group.
The study also showed that women using Zoladex had a 50 percent higher chance of being alive four years after starting treatment. Moore said it wasn’t clear why survival was increased and that more studies are needed.
A second study found women with breast cancer who have bone fractures or spinal cord compressions may safely reduce treatments with bisphosphonates like zoledronic acid, sold as Zometa by Novartis AG, from monthly to every three months after a year. The bone-strengthening drug is thought to reduce complications from fractures and spinal cord compressions but has rare, serious side effects like osteonecrosis of the jaw, where parts of the jawbone weaken and die.
The Novartis-funded study of 403 women found the less-frequent treatment wasn’t inferior.
The study showed “added benefits in reduced patient inconvenience and cost,” said Gabriel Hortobagyi, the study author and a professor of medicine at the University of Texas MD Anderson Cancer Center in Houston.
A third trial found that some patients with human papillomavirus-caused, less-aggressive oropharyngeal tumors, a type of head-and-neck cancer, can get lower doses of radiation without compromising their survival.
About 70 percent of newly diagnosed oropharyngeal cancers are related to HPV, a sexually transmitted disease. Those with HPV-positive tumors tend to have better outcomes than those who have tumors that are HPV-negative, the authors said.
Reducing the radiation dose helps decrease side effects including trouble swallowing, dry mouth, loss of taste, thyroid trouble and neck stiffness, the researchers said.