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William J. Gradishar, MD, FACP, FASCO
William J. Gradishar, MD, FACP, FASCO
Posted: Friday, January 31, 2025
In the phase III EUROPA trial, Icro Meattini, MD, of the University of Florence, Italy and colleagues observed that patients with breast cancer who received endocrine therapy had significantly reduced health-related quality of life over 24 months compared with patients who received radiation therapy. They believe that these findings, which were presented at the 2024 San Antonio Breast Cancer Symposium (SABCS; Abstract GS2-01), may help physicians and patients with shared decision-making.
This study included women aged 70 or older with early luminal-like breast cancer. After undergoing breast cancer surgery, patients were randomly assigned to receive exclusive endocrine therapy or exclusive radiation therapy. The primary endpoints were assessing the two-year health-related quality of life based on the global health status scale of the European Organisation for Research and Treatment of Cancer QLQ-C30 and the 5-year ipsilateral breast tumor recurrence rate.
More than 700 patients were randomly assigned to receive radiation therapy (n = 365) or endocrine therapy (n = 366) between February 2021 and June 2024. The interim analysis included 104 patients treated with radiation therapy and 103 treated with endocrine therapy. At baseline, the radiation therapy arm (n = 104) had a mean global health score of 71.9, whereas the endocrine therapy arm (n = 99) had a mean score of 75.5. Significant factors influencing global health score changes were treatment type (P = .045) and baseline global health status value (P < .0001), according to the investigators.
The adjusted mean differences between radiation therapy and endocrine therapy arms at 24 months showed a significant difference of 6.39, favoring the radiation therapy arm (P = .0453). Compared with radiation therapy at 24 months, endocrine therapy resulted in a more significant decline in most of the functional and symptom scales of the QLQ-C30 questionnaire. Contralateral breast cancer events occurred in three patients (two given radiation therapy, one given endocrine therapy). No breast cancer–related deaths were reported.
Disclosures: For full disclosures of the study authors, visit sabcs.org.
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