The Sequence 1/29-2/4
Empowering Prevention: Women in England Gain Access to Cancer-Fighting Drug
Empowering Prevention: Women in England Gain Access to Cancer-Fighting Drug
An estimated 289,000 post-menopausal women in England who are at moderate or high risk of breast cancer are now eligible for anastrozole, a drug that reduces their chances of developing the disease. Normally used to treat post-menopausal women with ER-positive breast cancer, the Medicines and Healthcare products Regulatory Agency in England has licensed it to be used as a preventive medicine, allowing National Health Service (NHS) England, the country’s publicly funded healthcare system, to offer the drug as a preventive measure.
Given the beneficial impact the drug’s new availability as a preventive treatment is expected to have in England, I thought I would take a look at anastrozole’s potential as well as its role here in the U.S.
What is anastrozole?
Anastrozole is a medication that can be taken to lower the risk of developing breast cancer. It is a form of chemoprevention known as an aromatase inhibitor (AI), a class of medicines that reduce the amount of estrogen in the body, depriving breast cancer cells of the fuel they need to grow and thrive.
What are the recommendations on prescribing anastrozole here in the U.S.?
The U.S.-based National Comprehensive Cancer Network (NCCN) guidelines recommend the AIs anastrozole and exemestane for post-menopausal women at high risk of developing breast cancer. Both have been shown to be effective in preventing breast cancer recurrence after menopause, as well as in reducing the risk of breast cancer in high-risk individuals. Individuals considered to be at high risk are those with a family history of breast cancer or a history of precancerous breast lesions.
And regarding the use of AIs as a preventive measure for hereditary cancer? There is little evidence supporting the use of AIs as an effective chemopreventive approach for individuals with pathogenic BRCA1 or BRCA2 variants.
How does this differ from the drug’s use in England?
Of an estimated 10 million women in the U.S. that may be eligible for this type of chemoprevention, less than 5% agree to take them. Experts in the U.K. hope the drug’s availability as a preventive treatment will prompt more at-risk women to take it. Baroness Delyth Morgan, chief executive of the charity Breast Cancer Now, said
Although the drug has traditionally been used to treat post-menopausal women with ER-positive breast cancer in the U.K., it is now being repurposed by the pioneering Medicines Repurposing Programme, under which a consortium of stakeholders are examining the potential use of existing drugs for the treatment of different conditions. The enterprise assesses the benefits of repurposing medicine by researching factors such as cost-effectiveness, utility, and implementation.
Now that it has been repurposed, women with a family history of multiple relatives with breast cancer or relatives that have developed breast cancer at a younger age will be able to access the drug through a breast cancer clinic they’re referred to by their primary care physicians.
What’s the takeaway?
Licensing anastrozole for a new use allows more women to live healthier lives, and represents the first step in increasing access for post-menopausal women in England who are at moderate or high risk of breast cancer. To me, this seems like a successful example of initiatives such as England’s Medicines Repurposing Programme. If entities like this can successfully keep up with the research published on the effects of medicines that might be repurposed and adapted, they can be more widely used for various preventive measures as the data expands.
Newsletter Sources:
https://www.canva.com/photos/MAFXRncbLno/
https://www.theguardian.com/society/2023/nov/07/drug-that-can-halve-breast-cancer-risk-offered-to-289000-women-in-england?utm_source=Sailthru&utm_medium=email&utm_campaign=Scan%20Tues%202023-11-07&utm_term=The%20Scan%20Bulletin
https://www.healthline.com/health/breast-cancer/aromatase-inhibitors-breast-cancer#takeaway
https://www.mayoclinic.org/diseases-conditions/breast-cancer/in-depth/breast-cancer/art-20045353
https://www.nccn.org/professionals/physician_gls/pdf/genetics_bop.pdf
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3744245/#:~:text=Based%20on%20age%20and%20breast%20cancer%20risk%2C,[3]%2C%20but%20less%20than%205%%20of%20high
https://www.england.nhs.uk/medicines-2/medicines-repurposing-programme/
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2813458?utm_source=Sailthru&utm_medium=email&utm_campaign=Scan%20Thurs%202024-01-04&utm_term=The%20Scan%20Bulletin
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4490034/
https://onlinelibrary.wiley.com/doi/10.1002/jgc4.1814?utm_source=Sailthru&utm_medium=email&utm_campaign=Scan%20Thurs%202023-10-26&utm_term=The%20Scan%20Bulletin
https://www.uptodate.com/contents/medications-for-the-prevention-of-breast-cancer-beyond-the-basics