Background: Treatment with an aromatase inhibitor for 5 years as up-front monotherapy or after tamoxifen therapy is the treatment of choice for hormone-receptor-positive early breast cancer in postmenopausal women. Extending treatment with an aromatase inhibitor to 10 years may further reduce the risk of breast-cancer recurrence.
Methods: We conducted a double-blind, placebo-controlled trial to assess the effect of the extended use of letrozole for an additional 5 years. Our primary end point was disease-free survival.
Results: We enrolled 1918 women. After a median follow-up of 6.3 years, there were 165 events involving disease recurrence or the occurrence of contralateral breast cancer (67 with letrozole and 98 with placebo) and 200 deaths (100 in each group). The 5-year disease-free survival rate was 95% (95% confidence interval [CI], 93 to 96) with letrozole and 91% (95% CI; 89 to 93) with placebo (hazard ratio for disease recurrence or the occurrence of contralateral breast cancer, 0.66; P=0.01 by a two-sided log-rank test stratified according to nodal status, prior adjuvant chemotherapy, the interval from the last dose of aromatase-inhibitor therapy, and the duration of treatment with tamoxifen). The rate of 5-year overall survival was 93% (95% CI, 92 to 95) with letrozole and 94% (95% CI, 92 to 95) with placebo (hazard ratio, 0.97; P=0.83). The annual incidence rate of contralateral breast cancer in the letrozole group was 0.21% (95% CI, 0.10 to 0.32), and the rate in the placebo group was 0.49% (95% CI, 0.32 to 0.67) (hazard ratio, 0.42; P=0.007). Bone-related toxic effects occurred more frequently among patients receiving letrozole than among those receiving placebo, including a higher incidence of bone pain, bone fractures, and new-onset osteoporosis. No significant differences between letrozole and placebo were observed in scores on most subscales measuring quality of life.
Conclusions: The extension of treatment with an adjuvant aromatase inhibitor to 10 years resulted in significantly higher rates of disease-free survival and a lower incidence of contralateral breast cancer than those with placebo, but the rate of overall survival was not higher with the aromatase inhibitor than with placebo. (Funded by the Canadian Cancer Society and others; ClinicalTrials.gov numbers, NCT00003140 and NCT00754845.).
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http://dx.doi.org/10.1056/NEJMoa1604700 | DOI Listing |
ACS Sens
December 2024
School of Mechanical Engineering, Southeast University, Nanjing 211189, People's Republic of China.
Background noise interferes with the accurate detection of early tumor biomarkers. This study introduces a method that effectively reduces background noise to enhance detection accuracy by combining a color-coded signaling approach with the unique fluorescent properties and room-temperature tunable quantum spin characteristics of fluorescent diamonds (FNDs) with nitrogen-vacancy centers. In this approach, a red signal indicates the presence of the target analyte within the spectral region, a green signal indicates its absence, and a yellow signal indicates the need for further analysis using FNDs' quantum spin properties for optical detection magnetic resonance (ODMR) to distinguish the FND signal from background noise.
View Article and Find Full Text PDFChempluschem
December 2024
Centre for Inorganic Chemistry, Chemistry, Bv 120, e/ 60 y 64, Nº1465, 1900, La Plata, ARGENTINA.
The redox imbalance, caused by depletion or generation of reactive oxygen species (ROS), is a key mechanism by which metal complexes exert anticancer effects. Carbidopa has shown the ability to inhibit the MDA-MB-231 cell line, a highly aggressive triple-negative human breast adenocarcinoma, by inducing reductive stress. The metal complex of carbidopa with zinc (ZnCarbi) was designed to modify carbidopa's structure and exhibited increased cytotoxicity against MDA-MB-231 cells.
View Article and Find Full Text PDFAm J Physiol Cell Physiol
December 2024
Department of Breast Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian, 350000, P.R. China.
Ubiquitin‑specific protease 35 (USP35) was found to be involved in various tumor progression, but its role in breast cancer remains largely unknown. USP35 mRNA and protein expression in breast cancer tissues and cells were evaluated by qPCR and Western bolt (WB), respectively. Subsequently, flow cytometry and EDU labeling were used to evaluate breast cancer cell apoptosis and proliferation.
View Article and Find Full Text PDFCardiol Ther
December 2024
Cardio-Oncology Program, Division of Cardiovascular Medicine, Department of Medicine, Lahey Hospital and Medical Center, 41 Mall Road, Burlington, MA, 01805, USA.
In addition to traditional risk factors, patients with breast cancer are at an increased risk of atrial fibrillation due to cancer itself and certain cancer therapies. Atrial fibrillation in these patients adds to their morbidity and mortality. The precise mechanisms leading to the increased atrial fibrillation in patients with breast cancer are not well understood.
View Article and Find Full Text PDFBiometals
December 2024
Department of Chemistry, Baba Mastnath University, Asthal Bohar, Rohtak, 124021, India.
The Schiff base metal complexes containing the transition metal ions Co(II), Ni(II) and Cu(II) were synthesized using their nitrate and acetate salts. An octahedral environment encircling metal complexes has been demonstrated by the findings of multiple spectroscopic approaches that were employed to demonstrate the structure of the metal complexes. The Coats-Redfern method of thermal analysis was employed to carry out the kinetic and thermodynamic calculations.
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