Acupuncture may reduce hot flashes in breast cancer patients receiving endocrine therapy
Patients with hormone receptor (HR)-positive breast cancer who received acupuncture experienced statistically significant and clinically meaningful reductions in hot flashes, according to results of a pooled analysis published in the American Cancer Society’s journal, American Association for Cancer Research. cancer.1
A pooled analysis of three clinical trials found that patients who received immediate acupuncture (IA), consisting of 20 acupuncture treatments over 10 weeks, experienced statistically significant improvements in endocrine symptom subscale scores (mean change ± standard error, 5.1 ± 0.9). P = .0003), hot flash score (–5.3 ± 0.9; P < .003) and Functional Assessment of Cancer Therapy (FACT) breast total score (8.0 ± 1.6; P = .0005). Patients who underwent delayed acupuncture control (DAC), which included patients who received 10 weeks of usual care and then transitioned to weekly acupuncture, had smaller changes in endocrine symptom scores (0.2 ± 1.0; P = .0003), hot flash score (–1.4 ± 0.9; P < .003), FACT-Breast total score (–0.01 ± 1.6; P = .0005).
“By managing [adverse] “This approach may make it easier for patients to stay on their prescribed medications, reduce the risk of breast cancer recurrence and improve long-term outcomes for breast cancer survivors,” lead author Weidong Lu, PhD, of the Department of Clinical Oncology at Dana-Farber Cancer Institute, said in a press release about the study findings.2 “In practice, patients interested in acupuncture for this purpose might begin with a short-term trial period to assess their response to treatment, particularly in terms of reduction in hot flashes and other symptoms. If the trial period shows positive results, patients might then enter a longer-term program of receiving acupuncture regularly for the duration of their antihormonal therapy.”
The primary endpoint of the study was the total change in endocrine symptoms subscale score from baseline to week 10. Secondary endpoints included change in weekly hot flash score, response rate defined as the proportion of patients with a 50% or greater reduction in hot flash score from baseline to week 10, and total change from baseline to week 10 in FACT-Breast subscale score and study outcome index.
From January 2019 to February 2022, researchers conducted three independent parallel randomized controlled trials at Dana-Farber Cancer Institute, USA (n = 78, NCT03783546), Catholic University of Daegu Medical Center, South Korea (n = 40, KCT0003618), and Jiangsu Provincial Hospital of Traditional Chinese Medicine, China (n = 40, ChiCTR2100045888), covering the entire analysis population (n = 158). The number of patients in the IA and DAC groups was 81 and 77, respectively. Each center used the same core acupuncture protocol, eligibility criteria, and study indicators, but worked with local regulatory bodies for approval and oversight.
Of 158 patients, 136 (86%) completed the study by week 10. Discontinuations after randomization occurred due to time constraints or interruptions related to COVID-19, with 12 (15%) in the IA group and 10 (13%) in the DAC group discontinuing before week 10. The researchers did not observe any treatment-related serious adverse events in either group.
Inclusion criteria at all centers included histologically or cytologically confirmed stage 0-III HR-positive breast cancer, regardless of HER2 status, and completion of surgery and chemotherapy or radiation therapy. Additional criteria included current receipt of adjuvant endocrine therapy, with or without ovarian suppression, for ≥4 weeks at the time of study enrollment, and a mean of at least 14 hot flashes in the week prior to screening that lasted for 4 weeks.
References
- Lu W, Giobbie-Hurder A, Tanasijevic A, et al. Acupuncture for hot flashes in hormone receptor-positive breast cancer: a pooled analysis of individual patient data from parallel randomized trials.. cancer. Published online June 14, 2024. doi:10.1002/cncr.35374
- Can Acupuncture Reduce Hot Flashes and Other Side Effects of Antihormonal Therapy for Breast Cancer? News Release. Wiley. June 24, 2024. Accessed July 2, 2024. https://tinyurl.com/mpe4apkv
