Adjuvant Endocrine Therapy for Women With Hormone Receptor–Positive Breast Cancer: ASCO Clinical Practice Guideline Focused Update

Review of 6 trials of extended aromatase inhibitor (AI) treatment published after 2012. Concluded that extension of AI treatment was not associated with an overall survival advantage but was associated with lower risks of breast cancer recurrence and contralateral breast cancer.

Based on the update evidence review ASCO now recommend that women with node positive breast cancer should receive up to 10 years of adjuvant treatment. Also recommended that many women with node-negative breast cancer should also consider extended therapy for up to a total of 10 years of adjuvant endocrine treatment based on considerations of recurrence risk using established prognostic factors. However the Panel noted that the benefits in absolute risk of reduction were modest and that, for lower-risk node-negative or limited node-positive cancers, an individualized approach to treatment duration based on considerations of risk reduction and tolerability was appropriate.

 

Bone-related toxic effects were more common with extended AI treatment.