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Menopause drug may reduce breast cancer growth in postmenopausal women, study finds
A menopause drug commonly used to relieve symptoms such as hot flushes may also help slow the growth of breast cancer cells in postmenopausal women, according to new clinical trial results.
The phase two trial, led by researchers at Northwestern University, found that Duavee—a medication prescribed for menopause-related symptoms—appeared to reduce cell growth in the breast tissue of women diagnosed with ductal carcinoma in situ (DCIS), a non-invasive form of breast cancer that remains within the milk ducts.
Almost 60,000 women are diagnosed with DCIS each year. While the condition is not invasive, it can indicate a higher risk of developing invasive tumours later in life.
In the study, 141 postmenopausal women with DCIS were recruited. Half received Duavee and the other half were given a placebo for the month between diagnosis and breast cancer surgery.
DCIS is most often detected during routine mammograms, makes up around 25 per cent of all breast cancer diagnoses, and has a 98 per cent recovery rate at 10 years when removed by surgery.
To reduce the risk of recurrence, many patients also undergo treatments such as radiation or hormone therapy following surgery—both of which can lead to significant side effects.
Duavee is a combination of oestrogen and bazedoxifene, a selective oestrogen receptor modulator (SERM) that either enhances or blocks the effects of oestrogen depending on the type of tissue. It is also used to treat osteoporosis.
Those who took Duavee showed notably less cell growth in their breast tissue by the time of surgery, and researchers reported “no impact on quality of life compared to placebo.”
Dr Swati Kulkarni is a surgeon at Northwestern University and lead investigator of the trial.
Kulkarni said: “What excites me most is that a medication designed to help women feel better during menopause may also reduce their risk of invasive breast cancer.
Importantly, participants taking Duavee did not experience the intolerable side effects often associated with cancer drugs.
Instead, the medication tended to improve quality of life in women already dealing with menopause symptoms such as night sweats and hot flushes.
Although larger studies are still needed to confirm whether Duavee can prevent invasive breast cancer, the researchers suggest that it could offer benefits to women with an elevated risk of breast cancer who also suffer from menopause-related symptoms.
This is especially significant because women with a history of cancer lesions are typically advised not to use hormone replacement therapy to relieve menopause symptoms, due to the potential risk of cancer returning.
The researchers concluded: “These results support consideration that Duavee is a safe option to manage menopausal symptoms for women concerned about their risk of developing breast cancer.
“They also provide supportive evidence that Duavee may reduce the risk of developing invasive breast cancer.”
The trial results have not yet been published in a peer-reviewed journal but were presented at the American Society of Clinical Oncology’s latest annual meeting.
Small bowel microbiome differences between women and men may help explain why some conditions are more common in women, a study suggests.
The small bowel microbiome is the community of microorganisms living in this part of the digestive tract, where they play vital roles in immune function, metabolism and hormonal regulation.
Researchers found differences between women and men in the composition and organisation of these microbial communities. One bacterial community containing Granulicatella was found only in women.
The study was conducted by investigators at Cedars-Sinai Health Sciences University.
Ruchi Mathur, director of clinical research and clinical operations for the Medically Associated Science and Technology (MAST) Program at Cedars-Sinai and corresponding author of the study, said: “One intriguing finding was a bacterial community containing Granulicatella, which we found only in women.
“Bacteria in this community appear at increased levels in women with polyendocrine metabolic ovarian syndrome, formerly known as polycystic ovary syndrome.”
The researchers also identified differences between women and men in how microbes in the small bowel produce fructans, complex carbohydrates known to trigger digestive symptoms in irritable bowel syndrome (IBS).
IBS is far more common in women than men.
Mathur, who is also a professor of medicine, said: “Our findings show that biological sex is a critical variable in the small bowel microbiome.
“We must consider it as we move toward more personalised approaches to understanding and treating disease.”
An experimental cancer drug reduced bone loss and body fat in mice modelling post-menopausal changes, early research suggests.
The compound, CADD522, appeared to strengthen bones and help the animals stay leaner after surgery designed to mimic hormonal changes seen after menopause.
The treatment remains at an early experimental stage and has so far only been tested in animals.
The study, led by the University of East Anglia, investigated CADD522, which was originally developed to block a protein involved in the growth and spread of several cancers.
Mice treated with the compound for eight weeks showed significant improvements in bone health. Scans found increased bone volume and better preservation of the honeycomb-like structures inside bones that are crucial for strength and resilience.
Blood tests suggested the treatment stimulated new bone growth without interfering with the body’s normal process of breaking down and rebuilding bone.
Dr Darrell Green, lead researcher from UEA’s Norwich Medical School, said: “Osteoporosis affects around one in three women over the age of 50, leaving sufferers vulnerable to painful fractures that can seriously impact quality of life.
“Current treatments exist, but many are plagued by side effects, safety concerns or inconvenient dosing schedules that make long-term use difficult.”
The researchers also found that mice receiving CADD522 weighed less than untreated mice despite eating the same amount of food.
They had less body fat and fewer fat deposits in their bone marrow, a process commonly seen after menopause and linked to declining bone health.
The team also examined brain tissue and found that the drug appeared to reverse several menopause-related changes in fatty acids.
Levels of omega-3 fats including DHA remained largely intact, while several other lipid abnormalities shifted back towards healthier patterns.
Green said: “We didn’t directly test for memory or thinking ability, but our work raises questions about whether this drug could one day help address wider menopause-related health problems.”
Safety experiments in mice, rats and dogs found that CADD522 could be taken orally and was well tolerated.
The compound also appeared to be metabolised more slowly in human tissue than in rodents, potentially improving its performance in people.
“This is still in the early stages and has so far only been tested in animals but we hope that the benefits will translate to humans to ultimately reduce fracture rates,” added Green.
The research was led by UEA in collaboration with the University of Maryland, the Scintillon Research Institute in San Diego and the University of Stirling.
Safety testing was funded by The Sir William Coxen Trust as part of the development of CADD522 as a childhood cancer treatment.
Weight loss surgery was linked to more regular periods and fewer polyendocrine metabolic ovarian syndrome (PMOS) symptoms in women aged 18 to 45 living with obesity in a recent study.
The researchers recommend that women undergoing the procedure have access to preconception care and reproductive counselling to support their reproductive health.
Researchers at the University of Surrey analysed data over 24 months from 84 women who underwent bariatric surgery and 18 women living with obesity who did not have surgery.
Of those who underwent surgery, 49 had gastric bypass procedures and 35 had gastric sleeve surgery.
Women who underwent metabolic bariatric surgery lost more than 30kg on average at 12 and 24 months after the procedure.
Among women with polycystic ovaries, the condition persisted in only 10 per cent after 24 months.
Women also reported a resolution of clinical hirsutism, or excess body hair, by 12 months.
Women who had previously experienced irregular periods reported more regular menstrual cycles after surgery.
Professor Martin Whyte, co-author of the study and professor of metabolic medicine at the University of Surrey, said: “A large proportion of those undergoing bariatric surgery are women of reproductive age, who may be planning a pregnancy in the coming years.
“So much remains unknown about the impact of this type of surgery on women who are planning to have children.
“This raises the question of when the ideal time after surgery is to conceive.”
Women have a higher prevalence of obesity than men, with 57 per cent of women in the UK classified as overweight and 27 per cent living with obesity, which can affect fertility and the health of an unborn baby.
The researchers said 17 women had healthy pregnancies following surgery.
Although this was not specifically examined in the study, no difference in birth weight was observed between babies conceived within or after the first year.
Dr Kathryn Hart, co-author of the study and associate professor in nutrition and dietetics at the University of Surrey, said: “What we have found is that bariatric surgery positively affects the reproductive health of women living with obesity and can improve the likelihood of them having a healthy pregnancy after surgery.
“Dysregulated hormone levels, irregular periods and conditions such as polycystic ovaries are affected by obesity.
“By reducing this, what we have seen is that it can lead to improvements without the need for medication.
“We would suggest that clinicians consider medical intervention for obesity to treat irregularities in the menstrual cycle and issues with fertility.”
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