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Breast cancer: new markers could enable the success of anti-hormone therapy to be estimated

(Vienna, 8th January 2014) Does a higher level of oestrogen cause the poor prognosis of overweight cancer patients receiving aromatase inhibitor therapy? Scientists at the MedUni Vienna and Vienna General Hospital’s Comprehensive Cancer Center have investigated this question and identified a highly promising marker in the process. This could in future serve as a progress parameter for estimating the success of endocrine therapies.

It has already been known for some time that there is a relationship between being overweight and being at higher risk of breast cancer. It is also known that oestrogens play a key role in the development of breast cancer. In post-menopausal women, oestrogen is primarily produced in fatty tissue. The currently most effective anti-hormone therapy for post-menopausal breast cancer involves the use of aromatase inhibitors, which are designed to prevent the formation of oestrogens in fatty tissue.

It has also been demonstrated in the past that the effectiveness of the aromatase inhibitor is significantly reduced in overweight breast cancer patients. In a current paper that has been published in the “British Journal of Cancer”, a study group led by Georg Pfeiler from the University Department of Gynaecology at the MedUni Vienna and Member of the Comprehensive Cancer Center (CCC) at the MedUni Vienna and Vienna General Hospital, has now investigated whether a higher oestrogen level in women with a high body mass index (BMI) could actually be the cause of a poorer prognosis.

Insignificant result
This prospective study enabled scientists to demonstrate that oestrogen levels in overweight women were higher both before therapy and during therapy with aromatase inhibitors, but were not significantly higher than those in patients of normal weight. Pfeiler adds: “We therefore need to interpret this result carefully to begin with and investigate the question further.”


Promising marker discovered
Pfeiler and his colleague Peter Dubsky, from the University Department of Surgery at the MedUni Vienna and also a Member of the CCC, were also able, however, through their work with the hormone FSH, to identify a marker that may possibly be suitable as a progress parameter that will enable the success of endocrine therapy with an aromatase inhibitor to be estimated. Pfeiler explains: “The advantage of this marker would be that it would be possible to detect early on whether endocrine therapy is helping an individual patient or not." Dubsky adds: “Knowing whether a treatment can be used successfully is extremely relevant, because it would spare many patients the need to take medications that are ineffective for them and allow other substances that will be effective to be used quickly.”

If the marker turns out to be usable, it will have another advantage: it can also be easily measured as part of a routine blood test, allowing statements to be made regarding the potential success of treatment quickly and easily.

Service: Cancer Research
“Impact of body mass index on estradiol depletion by aromatase inhibitors in postmenopausal women with early breast cancer” Pfeiler G, Königsberg R, Hadji P, Fitzal F, Maroske M, Dressel-Ban G, Zellinger J, Exner R, Seifert M, Singer C, Gnant M, Dubsky P. Br J Cancer. 2013 Sep 17;109(6):1522-7. doi: 10.1038/bjc.2013.499. Epub 2013 Sep 3.