What is the current status of ovarian suppression/ablation in women with premenopausal early-stage breast cancer?
The role of ovarian suppression/ablation (OS/OA) in premenopausal women with hormone receptor-positive breast cancer has been evolving for more than a century. It is clear that OS/OA is an effective adjuvant therapy for these women, but despite numerous studies enrolling thousands of women, many unanswered questions remain. In particular, a major question is whether additional benefit is gained with combination treatment comprising luteinizing hormone-releasing hormone (LH-RH) agonists and tamoxifen over tamoxifen alone. Ongoing trials also are assessing the coupling of aromatase inhibitors (traditionally contraindicated in these patients because of paradoxic stimulation of estrogen production) and LH-RH agonists. Any potential disease-free or overall survival advantage of combination treatment must be balanced against a possible increase in adverse effects and impairment of quality of life. This review focuses on new data on how to incorporate OS/OA into the rational treatment of this challenging patient population.
Higgins
Michaela J
MJ
Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD 21231, USA.
Davidson
Nancy E
NE
D000328:Adult; D047072:Aromatase Inhibitors / Q000494:pharmacology; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000517:prevention & control*; D002986:Clinical Trials as Topic; D018572:Disease-Free Survival; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000494:pharmacology; D006801:Humans; D008875:Middle Aged; D010053:Ovary / Q000502:physiology*; D017697:Premenopause; D016032:Randomized Controlled Trials as Topic; D012306:Risk; D013629:Tamoxifen / Q000494:pharmacology; D016896:Treatment Outcome
D047072:Aromatase Inhibitors; D013629:Tamoxifen; D007987:Gonadotropin-Releasing Hormone