Endocrine therapy used with targeted therapy is associated with similar quality of life in comparison to endocrine therapy used alone.

This study aimed to find out if endocrine therapy (ET) is best used alone or with targeted therapy in the treatment of hormone positive, HER2 negative advanced breast cancer. The study found that patients who used ET and targeted therapy together experienced a better quality of life in some regards compared to ET used alone. 

Breast cancer is classified into different subtypes depending on the presence or absence of certain receptors (proteins found on the surface of the cancer cells). These subtypes influence treatment options, and also directly affect disease prognosis. Hormone receptor positive cancer grows in response to female hormones such as estrogen. 

Breast cancer patients with hormone receptor positive cancers commonly receive endocrine treatment after initial surgery or radiotherapy. This treatment can include tamoxifen (Nolvadex) or aromatase inhibitors (for example, letrozole [Femara]). Targeted therapies work by inhibiting different proteins in the cell which slow tumor cell growth. These can include ribociclib or palbociclib.

It is unclear if ET is best used by itself, or with targeted therapy. 

This study looked at 11 different studies conducted between 2013 and 2016, including 2,949 patients.

Quality of life was maintained for patients using ET in the first line setting or in the case of its failure. Patients who used ET and targeted therapy together experienced a better quality of life in some regards relative to ET used alone. Most trials reported they were similar in the first line setting.

Common side effects experienced with targeted therapy and ET were nausea, fatigue, inflammation of the stomach and low white blood cell levels. ET used alone is associated with the changes in bone density, hot flushes and irregular menses among others. 

This study found that patients that used ET and targeted therapy together experienced a similar quality of life to those using ET alone. 

Further research is necessary to fully evaluate endocrine therapy and targeted therapy in the setting of advanced breast cancer. 

Discuss this article with your doctor.