New insights on the role of luteinizing hormone releasing hormone agonists in premenopausal early breast cancer patients.
Luteinising hormone releasing hormone agonists (LH-RHa) are effective in the treatment of advanced endocrine-sensitive breast cancer in premenopausal patients, but their role in the adjuvant setting has remained controversial for a long time. Tamoxifen for 5 years has been traditionally considered the standard endocrine therapy for premenopausal patients and this is still valid for many patients. However, the recently reported SOFT trial has suggested that adding ovarian function suppression (OFS) to tamoxifen could improve DFS in women at sufficient risk to warrant adjuvant chemotherapy and who remained premenopausal after this therapy. The administration of an aromatase inhibitor plus OFS represents an additional therapeutic option for hormone-receptor positive premenopausal breast cancer patients, according to the combined analysis of the SOFT and TEXT trials. Temporary ovarian suppression induced by LH-RHa has been recognized as an effective strategy to preserve ovarian function from the toxic effects of chemotherapy and is now recommended in young breast cancer patients with endocrine-insensitive tumors. In this review, we discuss recent data on the role of LH-RHa in combination with tamoxifen or with an aromatase inhibitor, and we comment on its role as a strategy to preserve ovarian function in young patients candidates for adjuvant or neo-adjuvant chemotherapy.
['Del Mastro|Lucia|L|', 'Rossi|Giovanni|G|', 'Lambertini|Matteo|M|', 'Poggio|Francesca|F|', 'Pronzato|Paolo|P|']
D000230:Adenocarcinoma D000328:Adult D018931:Antineoplastic Agents, Hormonal D000971:Antineoplastic Combined Chemotherapy Protocols D047072:Aromatase Inhibitors D001943:Breast Neoplasms D017326:Clinical Trials, Phase III as Topic D003131:Combined Modality Therapy D018572:Disease-Free Survival D004967:Estrogens D005260:Female D059247:Fertility Preservation D007987:Gonadotropin-Releasing Hormone D017273:Goserelin D006801:Humans D009376:Neoplasms, Hormone-Dependent D010053:Ovary D017697:Premenopause D011374:Progesterone D016032:Randomized Controlled Trials as Topic D013629:Tamoxifen D016896:Treatment Outcome
Breast cancer Endocrine therapy Aromatase inhibitor Infertility LH-RH agonists Ovarian ablation