23 June 2020

A recent interim analysis of the international “monarchE” trial has shown a significant decrease in the risk of breast cancer recurrence or death for those taking the drug Abemaciclib in combination with standard endocrine therapy, compared to standard adjuvant endocrine therapy alone.

The Waikato has been a centre for the monarchE trial since 2018. This clinical trial is investigating whether the oral drug Abemaciclib can improve the outcomes in women or men with high-risk hormone receptor-positive (HR+) and human epidermal receptor 2 negative (HER2-) early breast cancer. Abemaciclib stops the production of proteins in the body called CDK4 and CDK6, which are responsible for promoting cell growth. It has been shown to have antitumor activity and significantly reduce tumour growth, including breast cancer. Abemacicilib is taken twice daily in tablet form over a two year period.

90 percent of all breast cancer is diagnosed at an early stage and 70 percent of all breast cancers are HR+, HER2-, the most common subtype. Despite the progress in the treatment of breast cancer, approximately 30 percent of people diagnosed with HR+, HER2- early breast cancer are at risk of their cancer returning, potentially to incurable metastatic disease (spread of cancer to other parts of the body). This risk of recurrence increases based on certain  features such as breast cancer that has spread to the lymph nodes in the armpit, a larger tumour and a high grade (more aggressive) tumour .

“There has been a great need to improve endocrine therapy for breast cancer patients who are at high risk of disease recurrence.  The monarcE trial was specifically designed for patients with breast cancer at high risk for returning. Through the monarchE trial 5,637 people around the world have taken part in this research which has demonstrated positive results,” shares Waikato monarchE trial coordinator and research nurse Jenni Scarlet.  “If we can prevent women and men diagnosed with high-risk early-stage breast cancer from developing metastatic or incurable breast cancer then this would mean many lives saved”. The monarchE trial is headed in the Waikato by Medical Oncologist and WBCRT Trustee Dr Marion Kuper-Hommel.

In the Waikato, the Waikato Breast Cancer Research Trust has enabled six patients the opportunity to participate in the monarchE trial. The trial will now continue through to the completion date, estimated for June 2027. All participants will be followed to assess overall survival and other outcomes.