Maryam Lustberg, Director of the Center for Breast Cancer at Yale University School of Medicine, shared on LinkedIn:
“Reminding us that the final 15-year SOFT TEXT outcomes published in 2026 demonstrated that meaningful overal survival benefit was shown in high-risk hormone receptor positive breast cancer premenopausal subgroups treated with ovarian function suppression:
Prior chemotherapy, HER2-negative tumors (n=1,257): 15-year OS was 81.0% with exemestane+ (ovarian function suppression ) OFS, 77.1% with tamoxifen+OFS, and 76.8% with tamoxifen alone.
- A 4.2% absolute overal survival advantage for exemestane+OFS over tamoxifen.
Women <35 years: (n=241): 15-year OS was 82.5% with exemestane+OFS, 77.9% with tamoxifen+OFS, and 68.1% with tamoxifen alone.
- A 14.4% absolute OS benefit for exemestane+OFS over tamoxifen.
This study was conducted prior to the CDK 4/6 inhibitor data and the addition of targeted therapy likely further improves outcomes. The study also shows that lower risk patients can do just as well with tamoxifen alone. This is important because polarized messages on menopause management in breast cancer survivors are missing nuances on different risk levels of breast cancer. Ovarian function suppression has a key role in the highest risk groups even though it can be associated with a range of toxcities.
As an oncologist I care deeply about managing symptoms and selecting the most personalized therapy for my patients and many of my colleagues also practice similarly. Patients do deserve to know why ovarian function is being prescribed and the strength of the data. Better risk assessment tools can also further help in these nuanced discussions.”
Title: Final outcomes of the SOFT and TEXT phase III trials in premenopausal hormone receptor-positive early breast cancer
Authors: P A Francis, O Pagani, G F Fleming, B A Walley, M Colleoni, G Rubovszky, C Tondini, E M Ciruelos, H L Gomez, H R Bonnefoi, H J Burstein, C Chini, F Puglisi, S Spazzapan, A Bernardo, M A Climent, M Bellet, T Ruhstaller, B Bermejo, S K L Chia, S Martino, C E Geyer, M P Goetz, J N Ingle, V Stearns, N E Davidson, F Le Du, B Müller, R E Coleman, S Loibl, E P Winer, B Ruepp, S Loi, I Láng, A S Coates, R D Gelber, A Goldhirsch, M M Regan.
Read the full article.
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