title: New insights on the role of luteinizing hormone releasing hormone agonists in premenopausal early breast cancer patients.
abstract: 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.
authors.affiliation: UO Development of Innovative Therapies, IRCCS AOU San Martino-IST, National Institute for Cancer Research, L.go R. Benzi 10, 16132 Genova, Italy. Electronic address: lucia.delmastro@hsanmartino.it.
authors.forename: Lucia
authors.initials: L
authors.lastname: Del Mastro
authors.affiliation: UO Medical Oncology 2, IRCCS AOU San Martino-IST, National Institute for Cancer Research, L.go R. Benzi 10, 16132 Genova, Italy. Electronic address: giovanni.rossi.1689@gmail.com.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Rossi
authors.affiliation: UO Medical Oncology 2, IRCCS AOU San Martino-IST, National Institute for Cancer Research, L.go R. Benzi 10, 16132 Genova, Italy. Electronic address: matteo.lambertini@hsanmartino.it.
authors.forename: Matteo
authors.initials: M
authors.lastname: Lambertini
authors.affiliation: UO Medical Oncology 2, IRCCS AOU San Martino-IST, National Institute for Cancer Research, L.go R. Benzi 10, 16132 Genova, Italy. Electronic address: francesca.poggio.1987@gmail.com.
authors.forename: Francesca
authors.initials: F
authors.lastname: Poggio
authors.affiliation: UO Medical Oncology 2, IRCCS AOU San Martino-IST, National Institute for Cancer Research, L.go R. Benzi 10, 16132 Genova, Italy. Electronic address: paolo.pronzato@hsanmartino.it.
authors.forename: Paolo
authors.initials: P
authors.lastname: Pronzato
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy* / Q000628:therapy; D000328:Adult; D018931:Antineoplastic Agents, Hormonal / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D047072:Aromatase Inhibitors / Q000008:administration & dosage; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000628:therapy; 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 / Q000819:agonists*; D017273:Goserelin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D009376:Neoplasms, Hormone-Dependent / Q000188:drug therapy* / Q000628:therapy; D010053:Ovary / Q000187:drug effects; D017697:Premenopause; D011374:Progesterone; D016032:Randomized Controlled Trials as Topic; D013629:Tamoxifen / Q000008:administration & dosage; D016896:Treatment Outcome
chemical_list: D018931:Antineoplastic Agents, Hormonal; D047072:Aromatase Inhibitors; D004967:Estrogens; D013629:Tamoxifen; D017273:Goserelin; D007987:Gonadotropin-Releasing Hormone; D011374:Progesterone
keywords: Aromatase inhibitor; Breast cancer; Endocrine therapy; Infertility; LH-RH agonists; Ovarian ablation