Adding Ovarian Function Suppression to Tamoxifen Can Worsen Endocrine, Sexual Symptoms, Quality of Life
Adding OFS is associated with several patient-reported endocrine symptoms and impacts sexual functioning.
SAN ANTONIO—Adding ovarian function suppression (OFS) to adjuvant tamoxifen (T) for hormone receptor [HR]–positive early breast cancer is associated with several patient-reported endocrine symptoms and impacts sexual functioning, according to data from the randomized, phase 3 suppression of ovarian function trial (SOFT) presented at the 2014 San Antonio Breast Cancer Symposium.
Global quality-of-life measures of mood and physical well-being did not differ between women receiving tamoxifen alone and those who were also administered ovarian function suppression (OFS; in most cases, via monthly triptorelin injections), reported lead author Karin Ribi, PhD, and colleagues at the SOFT Investigators and International Breast Cancer Study Group in Bern, Switzerland.
But “overall, patients receiving T+OFS experienced worse endocrine symptoms and sexual functioning that those receiving tamoxifen alone during the first 2 years of treatment,” Dr. Ribi noted. Most differences were no longer apparent at 5 years.
Patients completed quality-of-life questionnaires at baseline, prior to therapy, including self-reported scales of physical well-being, mood and coping, endocrine symptoms, and sexual function. Of a total of 3,047 SOFT participants, 1,722 were ultimately included in the quality-of-life analysis.
Patients in the T+OFS group were “substantially more affected by hot flushes” than patients receiving tamoxifen alone at the short- and intermediate-term (6 and 24 months, respectively). Differences in hot flushes and sleep problems were “less pronounced in patients who had received prior chemo,” Dr. Ribi said.
“Sexual function decreased in all three groups, across all time periods,” Dr. Ribi noted. Sexual function problems (such as vaginal dryness, vaginal irritation, loss of sexual interest, and difficulty becoming sexually aroused) were less frequent among women with no history of chemotherapy compared to those with prior chemotherapy, Dr. Ribi noted.
“Differences between T+OFS and tamoxifen [alone] with respect to impaired symptom-specific quality of life, being burdened by treatment, and having delayed adaptation during the first 2 years of treatment were less pronounced for patients who received chemo prior to enrolling in SOFT,” Dr. Ribi added—noting that this was the patient cohort that benefited most from ovarian function suppression in terms of reduced breast cancer recurrence.
- Ribi K, Luo W, Bernhard J et al. S3-09. Presented at: San Antonio Breast Cancer Symposium 2014. Dec. 9-13, 2014; San Antonio, TX.