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Armando Orlandi: Landmark Meta-Analysis on Extended Endocrine Therapy in Early Breast Cancer

Armando Orlandi/photos.asco.org

Aug 11, 2025, 17:25

Armando Orlandi: Landmark Meta-Analysis on Extended Endocrine Therapy in Early Breast Cancer

Armando Orlandi, Medical Director at the Agostino Gemelli University Hospital Foundation IRCCS, shared a post on LinkedIn:

“BREAKING: Landmark Meta-Analysis on Extended Endocrine Therapy in Early Breast Cancer

The Early Breast Cancer Trialists’ Collaborative Group (EBCTCG) just published game-changing results in The Lancet from 22,031 postmenopausal women across 12 randomized trials.

Key findings:

Efficacy Results:

27% reduction in overall recurrence (RR 0.73, p<0.0001)
25% reduction in distant recurrence with 5 additional years of AI therapy
Clear dose-response: 5 years >> 2-3 years of extended therapy

Clinical Impact:

After previous AI therapy: 11.6% vs 15.2% recurrence risk (years 5-15)
Greater absolute benefit in node-positive disease
Effects consistent across age, tumor characteristics

Safety Profile:

No excess cardiovascular or other-cause mortality
Modest increase in bone fractures (+1.2% at 5 years)
High non-adherence (39%) but still significant benefits

Clinical Implications:

Decisions should balance individual risk-benefit ratio
Consider: nodal status, bone health, patient tolerance
~25% reduction in distant recurrence despite real-world adherence challenges

This meta-analysis provides the most robust evidence to date for personalized decision-making regarding extended AI therapy duration.”

Title: Extending the duration of endocrine treatment for early breast cancer: patient-level meta-analysis of 12 randomised trials of aromatase inhibitors in 22 031 postmenopausal women already treated with at least 5 years of endocrine therapy

Authors: Early Breast Cancer Trialists’ Collaborative Group (EBCTCG)

Read the Full Article.

Armando Orlandi