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Preserving Ovarian Function While Undergoing Breast Cancer Treatment

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Published on June 19, 2014

Dr. Julie Gralow, director of Breast Medical Oncology at Seattle Cancer Care Alliance, provides important highlights on a handful of trials for breast cancer, including one trial, SWOG SO230, that may allow young women undergoing breast cancer treatment to preserve ovarian function if they want to extend their families. Also, hear about the adjuvant bisphosphonate study that takes a look at reducing cancer cell survival in the bone and a comparison of toxicities.

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Transcript | Preserving Ovarian Function While Undergoing Breast Cancer Treatment

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That's how you’ll get care that's most appropriate for you.

Please remember the opinions expressed on Patient Power are not necessarily the views of Seattle Cancer Care Alliance, its medical staff or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

Well, there's always news about breast cancer coming out of the big ASCO, or American Society of Clinical Oncology, meeting, this year again in Chicago.  We were on the scene with our reporter, Carol Preston.  She sat down with the Seattle Cancer Care Alliance breast cancer expert Julie Gralow, she's world renowned, to get a rundown on the latest studies including one study looking at how the ovarian function of young women with breast cancer can be preserved, so they still have the option of having a child. 

And what that study showed, it was SWOG SO230, was that by giving a drug that blocks the ovaries from working, essentially, starting right before the chemo and then continuing it through the chemo versus just giving the chemo without that ovarian blocker, that women had a better what we call preservation of ovarian function.  Meaning although almost everybody went into a temporary menopause during the chemo that the women had a higher rate of having their ovaries returning to normal again at six months and at two years, and there were more babies born in the group that had the ovarian function suppression done. 

And also we were checking to make sure that this wouldn't be harmful to the patients, and so we looked at did they have more or less recurrences, more or less deaths due to breast cancer, and reassuringly there were actually less deaths due to breast cancer and less recurrences due to breast cancer—so big game changer for women at least estrogen?receptor positive women, and that's a subtype of breast cancer, who have breast cancer who are going to go on chemo. 

So the SWOG SO307 study that I'm the principal investigator for is a 6,000 person study comparing different drugs in this class, three different bisphosphonates. And while it's going to be several years before we see the comparison between the three, what we looked at were toxicities across the three drugs and patient preference for oral versus IV formulations, because two of the drugs are oral and one is intravenous in this study. 

And what we found was that the overall the side effects, the toxicities were quite low.  A scary side effect called osteonecrosis of the jaw that can happen with these drugs, whether using it for osteoporosis or for treating bone mets, that was really quite low, a little bit higher, 1.6 percent with the zoledronic acid (Zometa), the most potent of the drugs, and really almost nonexistent with clodronate which a weaker oral agent. 

And when we asked patients at enrollment and then when they finished their three years of treatment, if all the drugs end up being equal which would you prefer, oral or IV, 76 percent said oral and 24 percent said IV.  And it was exactly the same—although some switched their preference, it was exactly the same proportions when they went off study. 

So I think what's important is that we'd like to have choice, that IV is better for some, oral is better for some. And in the United States right now, only one of those three drugs is actually approved, and so we need to be able to help get patient choice.  There have been some big trials of placebo or no bisphosphonate versus bisphosphonate in breast cancer. And at least in the post-menopausal setting, it's appearing that they can help reduce recurrence.  So that's why we went on with this big trial comparing three different ones. 

And we await the final results of it, but now we have some comparative safety, and we understand a little bit about patients want choice.  For some, oral is better, for some, IV is better, and we need to recognize that and respond to that. 

Thanks for watching.  I'm Andrew Schorr.  Remember, knowledge can be the best medicine of all.  

Please remember the opinions expressed on Patient Power are not necessarily the views of Seattle Cancer Care Alliance, its medical staff or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

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