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Future breast cancer care: ESMO Breast Cancer 2024

Transcript: Premenopausal vs postmenopausal outcomes in the combined SOFT and TEXT trials

Last updated:6th Jun 2024
Published:6th Jun 2024

Professor Diana Lüftner

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A never-ending discussion in our tumour board conferences is do patients with premenopausal status and hormone receptor positive early breast cancer need an aromatase inhibitor if they have a lobular histology? We have only data so far from the postmenopausal setting coming from the big 0198 study which show that patients, if they have lobular histology, profit more from an aromatase inhibitor, in the big 98 study it was letrozole, than from tamoxifen. We did not have any data so far for premenopausal patients. And this was done now in a kind of combined analysis from the SOFT and TEXT trials which are old and have been presented very often, showing that the aromatase inhibitor in combination with a GnRH analogue is better in terms of survival analysis than tamoxifen alone but has more side effects. This has included relevant numbers of patients with lobular disease in comparison to ductal carcinoma, and now we have seen in a separate analysis on these patients with lobular carcinoma that there is a slightly, in terms of very small percentages, improvement of outcome if you also treat the lobular cancer patients with an aromatase inhibitor plus GnRH analogue in comparison tamoxifen alone. So this is a discussion that we have had very often. We didn't have any data. This is not a new drug. It is just a question that could be solved showing this analysis from SOFT and TEXT just from lobular carcinoma.

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