On 7th November 2023, NHS England reported that many thousands of women in the UK are set to ‘benefit’ massively from the ‘repurposing’ of a drug which aims to prevent breast cancer.
The drug in question, Anastrozole, is not new on the scene, having been used for many years in the treatment of breast cancer, but is being newly purposed as a mitigative solution instead.
An almost 50% decrease in the incidence of breast cancer in post-menopausal women who were predicted to be at high risk
Clinical trials report that taking the drug results in an almost 50% decrease in the incidence of breast cancer in post-menopausal women who were predicted to be at high risk of developing the disease.
The Medicines and Healthcare Products Regulatory Agency (MHRA) licensed anastrozole as a preventative drug in the first week of November, after initially being suggested for preventative use by the National Institute for Health and Care Excellence (NICE) in 2017.
Now ~300,000 women are set to be eligible for the drug, with the hope that a significant portion of these will choose to take anastrozole, preventing a projected 2000 breast cancer cases and saving ~£15 million worth of treatment on the NHS.
Affecting […] 1 in 7 women
Breast cancer is the most prevalent form of cancer in the UK, affecting approximately 1 in 7 women during their life.
It is characterised by many symptoms, including but not limited to, rashes and swelling of the breasts and lumps or thickened tissue. However, not all lumps are cancerous or a cause for concern – they may be entirely benign, but it is always best to have any changes checked by a doctor.
The risk of developing breast cancer increases with age, obesity and alcohol consumption, but you are also more susceptible if you have a family history of breast cancer or a previous cancer diagnosis.
Breast cancer can be fatal and is responsible for ~11,500 deaths in women and eighty-five deaths in men every year.
Generally detected through mammographic screening
Breast cancer is generally detected through mammographic screening (x-ray images of the breasts), however, these are not 100% reliable and mammograms may not detect the presence of cancer.
Women of the age 50-70 are offered screening every 3 years, but it is also available for those younger who are predicted to have a higher risk, e.g. due to a family history of breast cancer, and it is hoped in future years that the age range will widen in order to consistently screen more women every year.
Anastrozole is an aromatase inhibitor, a type of drug which reduces oestrogen levels in the body by preventing aromatase in fat tissues from converting other hormones into oestrogen (this does not prevent the production of oestrogen in the ovaries).
Side effects […] include hot flushes, weakness, joint pain/stiffness
This is important because oestrogen plays a role in stimulating the growth of breast cancer cells, so by reducing the amount of this hormone produced by the body, the risk of developing breast cancer is lowered.
Side effects of anastrozole, as identified in clinical trials, include hot flushes, weakness, joint pain/stiffness, nausea and headaches.
The initial study showing a 50% decrease in cases was conducted by providing 1mg tablets of anastrozole, or a placebo, to ~4000 women aged 40-70 over the course of 5 years. In 2020 a follow-up study showed the benefits of taking anastrozole to extend after the period in which the drug was taken.
The Medicines Repurposing Programme (MRP) builds on the importance of repurposing drugs that was displayed during the COVID-19 programme.
With the Programme established in 2021, anastrozole is the first medication to be licensed for repurpose, with the aim of further benefitting patients and NHS infrastructure by licensing more drugs for alternative innovative uses.
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