title: Role of gonadotropin-releasing hormone analogues in metastatic male breast cancer: results from a pooled analysis.
abstract: BACKGROUND
  Male breast cancer is a rare malignancy. Despite the lack of prospectively generated data from trials in either the adjuvant or metastatic setting, patients are commonly treated with hormone therapies. Much controversy exists over the use of gonadotropin-releasing hormone analogues in metastatic male breast cancer patients. We conducted this study to provide more concrete ground on the use of gonadotropin-releasing hormone analogues in this setting.
  
  
  METHODS
  We herein present results from a pooled analysis including 60 metastatic male breast cancer patients treated with either an aromatase inhibitor or cyproterone acetate as a monotherapy (23 patients) or combined with a gonadotropin-releasing hormone analogue (37 patients).
  
  
  RESULTS
  Overall response rate was 43.5% in patients treated with monotherapy and 51.3% with combination therapy (p = 0.6). Survival outcomes favored combination therapy in terms of median progression-free survival (11.6 months versus 6 months; p = 0.05), 1-year progression-free survival rate (43.2% versus 21.7%; p = 0.05), median overall survival (29.7 months versus 22 months; p = 0.05), and 2-year survival rate (64.9% versus 43.5%; p = 0.05).
  
  
  CONCLUSIONS
  In metastatic male breast cancer patients, the combined use of gonadotropin-releasing hormone analogues and aromatase inhibitors or antiandrogens seems to be associated with greater efficacy, particularly in terms of survival outcomes, compared with monotherapy. Collectively, these results encourage considering these agents in the metastatic setting.
authors.affiliation: Division of Medical Oncology B, "Regina Elena" National Cancer Institute, Via Elio Chianesi 53, 00144, Rome, Italy. dilauro@ifo.it.
authors.forename: Luigi
authors.initials: L
authors.lastname: Di Lauro
authors.affiliation: Division of Medical Oncology B, "Regina Elena" National Cancer Institute, Via Elio Chianesi 53, 00144, Rome, Italy. pizzuti8@hotmail.com.
authors.forename: Laura
authors.initials: L
authors.lastname: Pizzuti
authors.affiliation: Division of Medical Oncology B, "Regina Elena" National Cancer Institute, Via Elio Chianesi 53, 00144, Rome, Italy. maddalena.barba@gmail.com.|Scientific Direction, "Regina Elena" National Cancer Institute, Via Elio Chianesi 53, 00144, Rome, Italy. maddalena.barba@gmail.com.
authors.forename: Maddalena
authors.initials: M
authors.lastname: Barba
authors.affiliation: Division of Medical Oncology B, "Regina Elena" National Cancer Institute, Via Elio Chianesi 53, 00144, Rome, Italy. sergidome@libero.it.
authors.forename: Domenico
authors.initials: D
authors.lastname: Sergi
authors.affiliation: Biostatistics Unit, "Regina Elena" National Cancer Institute, Via Elio Chianesi 53, 00144, Rome, Italy. sperduti@ifo.it.
authors.forename: Isabella
authors.initials: I
authors.lastname: Sperduti
authors.affiliation: Department of Pathology, "Regina Elena" National Cancer Institute, Via Elio Chianesi 53, 00144, Rome, Italy. mottolese@ifo.it.
authors.forename: Marcella
authors.initials: M
authors.lastname: Mottolese
authors.affiliation: Department of Pathology, "Regina Elena" National Cancer Institute, Via Elio Chianesi 53, 00144, Rome, Italy. carla.azzurra@gmail.com.
authors.forename: Carla Azzurra
authors.initials: CA
authors.lastname: Amoreo
authors.affiliation: Division of Oncology, Spolverini Hospital, Ariccia, Italy. francabelli@alice.it.
authors.forename: Franca
authors.initials: F
authors.lastname: Belli
authors.affiliation: Division of Medical Oncology B, "Regina Elena" National Cancer Institute, Via Elio Chianesi 53, 00144, Rome, Italy. pvici@ifo.it.
authors.forename: Patrizia
authors.initials: P
authors.lastname: Vici
authors.affiliation: Leeds Institute of Cancer and Pathology, Wellcome Trust Brenner Building, University of Leeds, LS9 7TF, Leeds, UK. V.Speirs@leeds.ac.uk.
authors.forename: Valerie
authors.initials: V
authors.lastname: Speirs
authors.affiliation: Department of Medical Oncology, Campus Bio-Medico University of Rome, Rome, Italy. d.santini@unicampus.it.
authors.forename: Daniele
authors.initials: D
authors.lastname: Santini
authors.affiliation: Scientific Direction, "Regina Elena" National Cancer Institute, Via Elio Chianesi 53, 00144, Rome, Italy. demaria@ifo.it.
authors.forename: Ruggero
authors.initials: R
authors.lastname: De Maria
authors.affiliation: Division of Medical Oncology B, "Regina Elena" National Cancer Institute, Via Elio Chianesi 53, 00144, Rome, Italy. maugeri@ifo.it.|Scientific Direction, "Regina Elena" National Cancer Institute, Via Elio Chianesi 53, 00144, Rome, Italy. maugeri@ifo.it.
authors.forename: Marcello
authors.initials: M
authors.lastname: Maugeri-Saccà
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D047072:Aromatase Inhibitors / Q000378:metabolism*; D018567:Breast Neoplasms, Male / Q000188:drug therapy*; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000031:analogs & derivatives*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D055815:Young Adult
chemical_list: D047072:Aromatase Inhibitors; D007987:Gonadotropin-Releasing Hormone