One of the bigger news items to come out of last week’s San Antonio Breast Cancer Symposium was the long-awaited primary efficacy end-point analysis from the AZURE trial (Does Adjuvant Zoledronic acid redUce REcurrence in patients with high-risk localised breast cancer?).
Yes, the study did fail to meet the primary end-point of improved disease-free survival (DFS) in all women in the study group (women with stage II or III breast cancer at high risk of relapse). But the addition of zoledronic acid to neoadjuvant or adjuvant chemotherapy and/or hormonal therapy did signficantly improve survival in postmenopausal women. In a planned subanalysis, the researchers found that women who had undergone menopause at least 5 years earlier had a significant 29% improvement in overall survival.
This finding appears to be consistent with improved survival seen in the ABCSG-12 trial, among premenopausal women on medication to suppress ovarian function — and reduce estrogen levels. Estrogen levels also decline with menopause. This could be good news for a big portion of breast cancer patients. Dr. Robert Coleman, lead author of the AZURE study, noted that more than half of breast cancer patients are postmenopausal.