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Study shows postmenopausal women taking anastrozole as a chemopreventive treatment do not have impaired cognitive performance
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| Dr Valerie Jenkins |
02 September 2008
NEW results of a sub-study carried out as part of a worldwide breast cancer prevention study (IBIS-II) show that after two years of taking the aromatase inhibitor, anastrozole, postmenopausal women at high risk of breast cancer do not have impaired cognitive performance.
Early data on women using hormone replacement therapy (HRT) suggested oestrogen was important for maintaining levels of cognition and that reducing oestrogen levels might have a detrimental effect on this function. However, results of this sub-study do not support this belief.
The aim of the cognitive sub-study was to compare the effect of anastrozole on memory and attention in women enrolled in the IBIS-II breast cancer prevention study. Lead researcher Dr Valerie Jenkins from Cancer Research UK Psychosocial Oncology Group at the University of Sussex, assessed 227 women for psychological morbidity, endocrine symptoms and self-reported cognitive complaints. The women were interviewed by psychologists and given tasks including auditory verbal tasks, logical memory tasks and spatial span tests. Assessments were made at baseline, 6 months and 24 months after the start of treatment.
The results published in The Lancet Oncology showed no significant differences between the anastrozole group and the placebo group in terms of changes of attention or memory or in proportions of women experiencing psychological distress. The only difference observed between the groups was that significantly more women in the anastrozole group reported hot flushes.
Dr Valerie Jenkins said: "These findings should be reassuring in the short term for postmenopausal women being treated with anastrozole, their clinicians and carers."
IBIS-II lead researcher Professor Jack Cuzick from Barts and Ther London’s School of Medicine and Dentistry’s Centre for Epidemiology, Mathematics and Statistics said: "Because the IBIS-II trial is studying healthy women it is important to investigate any possible side effects of the treatment in great detail. These results provide reassurance that taking anastrozole will not impair cognitive performance."
The IBIS-II study is continuing to recruit postmenopausal women at high risk of breast cancer into the main IBIS-II study to determine how effective anastrozole will be at preventing breast cancer in high risk women.
Interested women should visit www.ibis-trials.org or contact the IBIS-II Recruitment Co-ordinator, Nicola Brebner on 0207 014 0223.
Ends
Dr Valerie Jenkins, Cancer Research UK Psychosocial Oncology Group, Brighton & Sussex Medical School, University of Sussex, Brighton, UK. Tel +44 (0) 1273 873 016/9
Notes to Editors
1) IBIS-II - The International Breast Cancer Intervention Study (IBIS-II) is being co-ordinated by Cancer Research UK and sponsored by Queen Mary, University of London. The trial is a large randomised double-blind placebo-controlled trial investigating if anastrozole can prevent breast cancer in postmenopausal women at high risk of the disease. It is taking place in 21 countries around the world.
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The Prevention arm of the trial aims to recruit 6000 postmenopausal women who are at increased risk of developing breast cancer. Women can take part in the trial if they are aged between 40-70 years and are not on HRT.-
The DCIS arm of the trial will recruit 4000 postmenopausal women who have been diagnosed with and had surgery to remove DCIS (Ductal Carcinoma in Situ). This part of the trial is investigating which of the two drugs, anastrozole or tamoxifen, can best prevent breast cancer from recurring. Women who have had a mastectomy cannot join this arm of the trial but may be eligible to join the Prevention arm.2) One of the strengths of the cognitive sub-study is that its double-blind design provides a better assessment of putative cognitive impairment than cross-sectional or observational studies.
3) One of the weaknesses of the study is the relatively small study sample, but this sample is significantly larger than those in other published neuropsychological studies involving women with breast cancer.