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Switch in Breast-Cancer Drugs Shows Benefit

Rating

3 Star

Switch in Breast-Cancer Drugs Shows Benefit

Our Review Summary

The story reports on a recent meta-analysis that demonstrated switching from tamoxifen to anastrozole (trade name Arimidex) can decrease the risk of breast cancer recurrence in women with estrogen-positive tumors. Switching hormone therapies mid-course would be a novel approach to hormone therapy treatment.  However, the story does not provide an absolute benefit of this switch; many women with early-stage estrogen-positive cancer have very high survival to begin with, so the 29% additional relative risk reduction may actually not be a very big number. 

The story does not provide the cost of anastrozole or tamoxifen.  Hormone therapy is a regimen of daily medication for 5 years., so whether switching medications or continuing with tamoxifen has major cost implications is debatable.  Instead of just reporting sales figures for Astra-Zeneca, the story should have explained how much these drugs costs consumers.

The story does not discuss the potential side effects of anastrozole, one of the aromatase inhibitor class of hormone therapies. These are listed in the source article for this story. The paper just had to report them. Anastrozole and tamoxifen may increase menopausal symptoms such as hot flashes or vaginal discomfort, though anastrozole slightly less so than tamoxifen.  Also, anastrozole may increase the risk of bone or joint pain, and it may also increase LDL or “bad” cholesterol.

Lastly, there are no additional sources of information and no attempts at independent corroboration within this story. There is also no discussion that AstraZeneca, makers of anastrozole, funded the research and currently pay the lead authors of the study speaking fees and other honoraria. 

Criteria

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

The story does not provide the cost of either anastrozole or tamoxifen. Hormone therapy is a regimen of daily medication for 5 years, so whether switching medications or continuing with tamoxifen has major cost implications is debatable.  Instead of just giving sales figures for Astra-Zeneca, the story should have explained how much these drugs cost consumers.

 

Does the story adequately quantify the benefits of the treatment/test/product/procedure?

Not Satisfactory

The story only presents the relative risk reduction of making the switch from tamoxifen to anastrozole. No absolute benefit provided.

Does the story adequately explain/quantify the harms of the intervention?

Not Satisfactory

The story does not mention the potential side effects of aromatase inhibitors. Both hormone therapies may increase menopausal symptoms such as hot flashes or vaginal discomfort, though anstrozole slightly less so than tamoxifen.  Anastrozole may increase the risk of bone or joint pain and possibly may increase cholesterol.

Does the story seem to grasp the quality of the evidence?

Not Satisfactory

That story does not adequately describe the study design, which was a meta-analysis of three randomized clinical trials. The story says that the switch to anastrozole reduces the risk of dying (from breast cancer) by 29%, however, the data in these studies are only for 5 years, so long-term survival is unknown. Also, the story does not provide an absolute benefit; many of these women have very high survival to begin with, so the 29% additional risk reduction may not be a very big number.

 

Does the story commit disease-mongering?

Satisfactory

The story does not engage is disease mongering. The story reports on a recent study relevant for women who have been diagnosed with early-stage breast cancer.

Does the story use independent sources and identify conflicts of interest?

Not Satisfactory

There are no additional sources of information and no attempts an independent corroboration.  The story does not mention that AstraZeneca, makers of anastrozole, funded the research and the lead authors of the study receive speaking fees and other honoraria from AstraZeneca.

Does the story compare the new approach with existing alternatives?

Satisfactory

The story mentions that this hormone therapy to prevent breast cancer recurrence is in addition to surgery. Tamoxifen, another hormone therapy, is also mentioned.

Does the story establish the availability of the treatment/test/product/procedure?

Satisfactory

The story notes that a hormone therapy, anastrozole (trade name Arimidex), was FDA-approved in 2005 for the treatment of early-stage breast cancer (after surgery). What is important, but is not emphazied is that this drug is only for post-menopausal women.

Does the story establish the true novelty of the approach?

Satisfactory

The story mentions that switching from tamoxifen to anastrozole would be a newer approach to hormone therapy treatment for women diagnosed with estrogen-positive breast cancer.

Does the story appear to rely solely or largely on a news release?

Not Applicable

We cannot determine if this information is from a press release. No independent sources are interviewed to provide perspective on the study and shift in treatment. 

Total Score: 4 of 9 Satisfactory

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