A 60-year-old postmenopausal woman with ER+/PR+/HER2- early breast cancer completes 5 years of tamoxifen. She is assessed for extended adjuvant endocrine therapy. The MA.17R trial evaluated what approach?
- A Continuing tamoxifen for additional 5 years versus stopping
- B Switching to exemestane after 5 years of letrozole
- C Adding abemaciclib to letrozole for CDK4/6 inhibition
- D Extending letrozole for an additional 5 years (total 10 years of AI therapy) versus placebo after 5 years of AI ✓
Explanation
The MA.17R trial assessed extended adjuvant letrozole therapy for an additional 5 years (total 10 years of AI) versus placebo in postmenopausal women who had completed 4.5-6 years of AI therapy. The trial demonstrated significantly improved 5-year disease-free survival with extended letrozole (95% vs 91%) with a reduction in contralateral breast cancer, though at the cost of higher bone loss. Extended AI therapy for up to 10 years is now an option for high-risk patients. The ATLAS and aTTom trials showed similar benefits for 10 years of tamoxifen in premenopausal women.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.