CoBrCa 2016 | Two trials, SOFT and TEXT, investigating combination treatments for patients with breast cancer

Antonio Llombart, MD, PhD, of the University Hospital Arnau de Vilanova, Valencia, Spain, discusses two trials, the SOFT and TEXT trials, investigating combination treatments for patients with breast cancer (NCT00066690 and NCT00066703) at the 2016 World Congress on Controversies in Breast Cancer (CoBrCa) in Barcelona, Spain. We have known for a while that endocrine treatment is the base for endocrine sensitive tumors. In fact, the first active treatment that we knew for breast cancer was ovarian suppression. Right now the question is, if the suppression of ovarian function is effective when we have other treatments and whether or not adding ovarian suppression to these treatments could increase activity and prevent relapses. Many trials in the past have failed but over the past 10 years, two trials, the SOFT and the TEXT trials, addressing this specific question, have been very well designed guaranteeing a clear answer. The combination of both analysis shows that ovarian suppression with endocrine therapy is slightly superior to tamoxifen (a type of endocrine therapy) alone. This means that there are some patients that could benefit from the combination while a large number of patients can continue to be treated with tamoxifen alone. The long discussion has been deciding who the good candidates are and who will benefit from this combination. These are most likely patients at a high risk of relapse. However, a major concern is toxicities of the treatment. These toxicities are not as big as with chemotherapy but are uncomfortable, especially with the treatment lasting 4 or 5 years. These include hot flushes, weight gain and loss of sexual appetite, decreasing quality of life.