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Calls for breast cancer drug to be made immediately available on NHS Breast cancer drug 'halves likelihood of high-risk women developing disease'
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A drug not yet available on the NHS has been found to be better at preventing breast cancer than those approved for use, leading to urgent calls for the National Institute for Health and Care Excellence to make the drugs accessible immediately.A drug not yet available on the NHS has been found to be better at preventing breast cancer than those approved for use, leading to urgent calls for the National Institute for Health and Care Excellence to make the drugs accessible immediately.
The drug anastrozole has been found to halve the likelihood of high-risk women developing the disease and to have fewer side effects, according to a study published today in the medical journal the Lancet. The the Ibis II study, funded by Cancer Research UK and led by Queen Mary University of London, tracked almost 4,000 postmenopausal women at high risk of breast cancer and found that those who took anastrozole for five years were 53% less likely to develop the disease than women who took a placebo. The drug anastrozole has been found to halve the likelihood of high-risk women developing the disease and to have fewer side effects, according to a study published today in the medical journal the Lancet. The the Ibis-II study, funded by Cancer Research UK and led by Queen Mary University of London, tracked almost 4,000 postmenopausal women at high risk of breast cancer and found that those who took anastrozole for five years were 53% less likely to develop the disease than women who took a placebo.
The news comes after Nice took the historic step this year of giving all women over 30 in England and Wales judged to be at moderate or high risk of breast cancer access to one of two drugs: tamoxifen and raloxifene. But the study suggests that neither is as effective as anastrozole and had more side effects, leading for calls for its introduction into the NHS. The results have been disclosed after Nice took the historic step this year of giving all women over 30 in England and Wales judged to be at moderate or high risk of breast cancer access to one of two drugs: tamoxifen and raloxifene. But the study suggests that neither is as effective as anastrozole and had more side effects.
Professor Jack Cuzick, lead researcher, called the study an "exciting development" in breast cancer prevention.Professor Jack Cuzick, lead researcher, called the study an "exciting development" in breast cancer prevention.
"We now know Anastrozole should be the drug of choice when it comes to reducing the risk of breast cancer in postmenopausal women with a family history or other risk factors for the disease. This class of drugs is more effective than previous drugs such as tamoxifen and crucially, it has fewer side effects," said Cuzick, who the head of the Centre for Cancer Prevention at Queen Mary's. "We now know Anastrozole should be the drug of choice when it comes to reducing the risk of breast cancer in postmenopausal women with a family history or other risk factors for the disease. This class of drugs is more effective than previous drugs such as tamoxifen and crucially, it has fewer side effects," said Cuzick, who is the head of the Centre for Cancer Prevention at Queen Mary's.
"[We] strongly urge the National Institute for Health and Care Excellence to consider adding anastrozole to their recommended drugs for women who are predisposed to developing breast cancer.""[We] strongly urge the National Institute for Health and Care Excellence to consider adding anastrozole to their recommended drugs for women who are predisposed to developing breast cancer."
He added that the side effects often associated with oestrogen-depriving drugs such as tamoxifen and raloxifene, including acute aches and pains, were "only slightly higher than in the placebo arm" of the anastrozole study.He added that the side effects often associated with oestrogen-depriving drugs such as tamoxifen and raloxifene, including acute aches and pains, were "only slightly higher than in the placebo arm" of the anastrozole study.
Anastrozole is also cost-effective as it is out of patent and costs £1.95 for a 28 tab pack, a comparable cost to tamoxifen, according to charity Breakthrough Breast Cancer. But it could be several years until Nice reviews its guidance, although it can be prescribed to patients that are deemed appropriate by their clinician, according to a spokeswoman. The study tracked 3,864 postmenopausal women at high risk of breast cancer. Half were given 1mg of anastrozole a day while the rest were given a placebo. In the five years of follow up, 40 women in the anastrozole group developed breast cancer compared with 85 women in the placebo group.
Anastrozole works by preventing the body from making oestrogen – which fuels many breast cancers – and has is already used to treat postmenopausal women with oestrogen receptor positive breast cancer. Women were judged to be at high risk of breast cancer if they had two or more relatives with the disease, a mother or sister who developed it before the age of 50, or in both breasts, or having certain high risk types of benign breast disease.
The drug is also cost-effective as it is out of patent and costs £1.95 for a 28 tab pack, a comparable cost to tamoxifen, according to charity Breakthrough Breast Cancer. But it could be several years until Nice reviews its guidance, although it can be prescribed to patients that are deemed appropriate by their clinician, according to a spokeswoman.
The charity's head of policy, Dr Caitlin Palframan, said: "The challenge will be ensuring drugs like these are actually offered on the NHS, as many eligible women still don't have access to the risk reducing treatments already recommended in national guidelines."The charity's head of policy, Dr Caitlin Palframan, said: "The challenge will be ensuring drugs like these are actually offered on the NHS, as many eligible women still don't have access to the risk reducing treatments already recommended in national guidelines."
More than 10,000 postmenopausal women die of breast cancer each year, although only 1 in 5 women with breast cancer has a significant family history, according to the charity. An estimated 488,000 women at moderate or high risk of the disease could be eligible and benefit from risk reducing drugs such as tamoxifen, raloxifene, and anastrozole.More than 10,000 postmenopausal women die of breast cancer each year, although only 1 in 5 women with breast cancer has a significant family history, according to the charity. An estimated 488,000 women at moderate or high risk of the disease could be eligible and benefit from risk reducing drugs such as tamoxifen, raloxifene, and anastrozole.
Professor Tony Howell, scientific director of the charity Genesis Breast Cancer prevention and co-lead of the study, called the results "remarkable", adding: "[This] is a significant step for postmenopausal women, who have been identified as high risk. This provides us with another preventative treatment option, which has the potential to save and prolong the lives of thousands of women.Professor Tony Howell, scientific director of the charity Genesis Breast Cancer prevention and co-lead of the study, called the results "remarkable", adding: "[This] is a significant step for postmenopausal women, who have been identified as high risk. This provides us with another preventative treatment option, which has the potential to save and prolong the lives of thousands of women.
"The results from Ibis II have the potential to bring us one step closer to creating a future without breast cancer. We strongly agree with Jack Cuzick's urge to Nice, which ought to act immediately and look into making the drug accessible as a means for breast cancer prevention." "The results from Ibis-II have the potential to bring us one step closer to creating a future without breast cancer. We strongly agree with Jack Cuzick's urge to Nice, which ought to act immediately and look into making the drug accessible as a means for breast cancer prevention."
The study tracked 3,864 postmenopausal women at high risk of breast cancer. Half were given 1mg of anastrozole a day while the rest were given a placebo. In the five years of follow up, 40 women in the anastrozole group developed breast cancer compared with 85 women in the placebo group.
Anastrozole works by preventing the body from making oestrogen – which fuels many breast cancers – and has is already used to treat postmenopausal women with oestrogen receptor positive breast cancer. Women were judged to be at high risk of breast cancer if they had two or more relatives with the disease, a mother or sister who developed it before the age of 50, or in both breasts, or having certain high risk types of benign breast disease.
Kate Law, director of clinical research at Cancer Research UK, said: "This landmark study shows that anastrozole could be valuable in helping to prevent breast cancer in women at higher than average risk of disease. We now need accurate tests that will predict which women will most benefit from anastrozole and those who will have the fewest side-effects."Kate Law, director of clinical research at Cancer Research UK, said: "This landmark study shows that anastrozole could be valuable in helping to prevent breast cancer in women at higher than average risk of disease. We now need accurate tests that will predict which women will most benefit from anastrozole and those who will have the fewest side-effects."
Dr Harpal Kumar, Cancer Research UK's chief executive, said the charity had funded the trial for more than 10 years. "We're delighted that the results will now offer women at high risk of breast cancer a new option to significantly reduce their chance of developing the disease," he said. "By supporting large trials such as this, which take a long time to complete, we can make discoveries that will help us to save many more lives in the future."Dr Harpal Kumar, Cancer Research UK's chief executive, said the charity had funded the trial for more than 10 years. "We're delighted that the results will now offer women at high risk of breast cancer a new option to significantly reduce their chance of developing the disease," he said. "By supporting large trials such as this, which take a long time to complete, we can make discoveries that will help us to save many more lives in the future."
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