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Suitable trial designs and cohorts for preventive breast cancer agents

Kathrin Strasser-Weippl1, Paul E Goss

  • 1Center for Oncology, Hematology and Palliative Care, Wilhelminen Hospital, Montleartstrasse 36, A-1160 Vienna, Austria.

Nature Reviews. Clinical Oncology
|October 9, 2013
PubMed

Insights

Chemoprevention for estrogen receptor (ER)-positive breast cancer is effective but underused due to risk communication challenges. New agents and biomarkers are needed for both ER-positive and ER-negative breast cancer prevention.

Area of Science:

  • Oncology
  • Preventive Medicine
  • Pharmacology

Background:

  • Selective ER modulators and exemestane show efficacy in preventing ER-positive breast cancer.
  • Current uptake of breast cancer chemoprevention is low due to challenges in risk assessment and benefit communication.

Purpose of the Study:

  • To highlight the need for improved strategies in breast cancer chemoprevention.
  • To identify key areas for advancement in the development and implementation of chemopreventive agents.

Main Methods:

  • Review of existing chemopreventive agents for ER-positive breast cancer.
  • Discussion of barriers to clinical adoption and development of new agents.
  • Exploration of necessary advancements in biomarker research, risk prediction tools, and trial design.

Main Results:

  • Effective chemoprevention exists for ER-positive breast cancer but faces poor clinical uptake.
  • Development of agents for ER-negative breast cancer is hindered by a lack of biomarkers and targets.
  • Accessible biomarkers, improved risk-benefit communication tools, and innovative trial designs are crucial.

Conclusions:

  • Advances in biomarker research, risk prediction, and trial design are essential for integrating breast cancer chemoprevention into clinical practice.
  • Development of accessible, blood-based biomarkers will be pivotal for future chemoprevention strategies.
  • Addressing regulatory and financial considerations can facilitate the development and implementation of new chemopreventive agents.

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