Smoking Status, Age May Impact Efficacy of Breast Cancer Meds

The study included 1,065 breast cancer patients without preoperative treatment
The study included 1,065 breast cancer patients without preoperative treatment

According to a study published in the British Journal of Cancer, a common medication for breast cancer may have reduced efficacy in patients who smoke vs. non-smokers. 

Helena Jernström, associate professor and principal investigator, and colleagues conducted a study to investigate whether preoperative smoking was correlated with prognosis in various treatment groups. The cohort included 1,065 patients in Lund, Sweden, without preoperative treatment between 2002-2012. Smoking status was compared in relation to the patient and tumor characteristics, and prognosis in different treatment groups. 

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At the preoperative visit, 21% of patients stated that they were either a regular smoker or a "social smoker." Of the 1,016 patients included in the survival analysis, no significant association between smoking and the risk of breast cancer events were seen (adjusted HR 1.45, 95% CI: 0.95–2.20). 

For patients aged ≥50 years with estrogen receptor-positive tumors who were treated with aromatase inhibitors (AI), smoking was associated with the risk of breast cancer events (adjusted HR 2.97, 95% CI: 1.44–6.13), distant metastasis (adjusted HR 4.19, 95% CI: 1.81–9.72), and death (adjusted HR 3.52, 95% CI: 1.59–7.81). 

"The treatment with aromatase inhibitors worked significantly better in the non-smoking patients. However, we saw little or no difference between smokers and non-smokers among patients treated with the drug tamoxifen, radiotherapy or chemotherapy," reported Jernström.

Overall, preoperative smoking was only associated with a higher risk of breast cancer events and distant metastasis in AI-treated patients. "If confirmed, smoking status should be taken into consideration when selecting an endocrine therapy." 

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