Adjuvant hormonal therapy in young breast cancer patients

Lambertini, Matteo; Azim, Hatem A.

doi:10.2217/bmt.13.67

Cited by 3 publications

(3 citation statements)

References 23 publications

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“…All patients with early-stage luminal breast cancer are candidates to receive an anticancer treatment that include the use of adjuvant endocrine therapy: until recently, 5 years of tamoxifen has been considered the standard of care in managing young women with endocrine-sensitive disease [37]. The meta-analysis of the Early Breast Cancer Trialists' Collaborative Group (EBCTCG) showed that 5 years of tamoxifen significantly reduced breast cancer mortality throughout the first 15 years [38].…”

Section: Adjuvant Endocrine Therapymentioning

confidence: 99%

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News on the medical treatment of young women with early-stage HER2-negative breast cancer

Lambertini

Poggio

Vaglica

et al. 2016

Expert Opinion on Pharmacotherapy

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For women candidates to receive (neo)adjuvant chemotherapy, anthracycline- and taxane-based regimens are standard of care. In high-risk patients, dose-dense regimens should be preferred; in women with triple-negative breast cancer and BRCA mutations, the addition of platinum compounds may also be considered. Several adjuvant endocrine therapy options have become available for the treatment of premenopausal women with early-stage luminal breast cancer. Specifically, young patients at low risk of relapse may be safely spared chemotherapy: endocrine therapy alone with tamoxifen for 5 years is the most appropriate treatment. In women at higher risk of relapse, ovarian function suppression is therapeutic: in this scenario, luteinizing hormone-releasing hormone agonists (LHRHa) should be considered in addition to tamoxifen or aromatase inhibitors. To women concerned about the possible risk of chemotherapy-induced premature ovarian failure, the use of temporary ovarian suppression with LHRHa should be proposed as a valid strategy to potentially preserve ovarian function and fertility.

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Section: Adjuvant Endocrine Therapymentioning

confidence: 99%

“…Since aromatase inhibitors are becoming standard of care for post-menopausal patients [45], the findings from the ATLAS and aTTom trials should be considered of higher relevance for young breast cancer patients [37].…”

Section: Optimal Duration Of Adjuvant Endocrine Therapymentioning

confidence: 99%

News on the medical treatment of young women with early-stage HER2-negative breast cancer

Lambertini

Poggio

Vaglica

et al. 2016

Expert Opinion on Pharmacotherapy

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“…It is an important means to reduce the risk of recurrence of these patients. 5-10 years tamoxifen (TAM) treatment is the gold standard for adjuvant endocrine therapy in premenopausal hormone receptor (HR) positive breast cancer patients [4][5][6][7][8][9]. Since the discovery of aromatase inhibitors (AIs), various clinical studies [10][11][12][13] have proved that AIs are better than TAM for adjuvant treatment of early postmenopausal breast cancer, and AIs have become the first-line therapy for postmenopausal women with early breast cancer.…”

Section: Introductionmentioning

confidence: 99%

Ovarian Function Suppression Plus Aromatase Inhibitors or Tamoxifen in Premenopausal HR-positive Breast Cancer

2020

J Cancer Immunol

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Ovarian Function Suppression in Premenopausal Women with Early-Stage Breast Cancer

Lambertini

Mastro

Viglietti

et al. 2017

Curr. Treat. Options in Oncol.

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Breast cancers arising in young women are biologically more aggressive, and most of these patients are candidates to receive aggressive treatments that include the use of chemotherapy. As most of these tumors express the hormone receptors (i.e., luminal disease), these patients are also candidates to adjuvant endocrine therapy. Chemotherapy-induced amenorrhea showed to be prognostic in young patients with luminal breast cancer. However, the role of ovarian function suppression (OFS) in addition to standard adjuvant treatments has been largely debated over the past years. Recently, several studies have provided important insights on the role of OFS. Currently, the use of tamoxifen alone without prior cytotoxic therapy can be considered a very effective treatment option in young patients with hormone receptor-positive breast cancer at low risk of relapse. On the other hand, for patients at higher risk of relapse as those who are candidates to (neo)adjuvant chemotherapy, OFS proved to be beneficial, and therefore luteinizing hormone-releasing hormone agonists (LHRHa) should be considered in addition to tamoxifen or aromatase inhibitors (AI). However, toxicity is considerable and patients should be actively engaged in decision-making. Finally, in young breast cancer patients who are candidates to (neo)adjuvant chemotherapy, loss of ovarian function and fertility may be a concern. Besides other techniques, recent results showed that temporary OFS with LHRHa during cytotoxic treatment can be considered a reliable strategy to preserve gonadal function and fertility. Despite the recent advances in the field, several gray zones remain unanswered: the role of OFS plus AI in women who remained premenopausal after 5 years of tamoxifen, the optimal extended approach in women treated with 5 years of OFS plus AI, and the role of temporary OFS with LHRHa during chemotherapy in the specific subgroup of patients with BRCA mutations and in women undergoing this strategy after prior embryo/oocyte cryopreservation.

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Adjuvant hormonal therapy in young breast cancer patients

Cited by 3 publications

References 23 publications

News on the medical treatment of young women with early-stage HER2-negative breast cancer

News on the medical treatment of young women with early-stage HER2-negative breast cancer

Ovarian Function Suppression Plus Aromatase Inhibitors or Tamoxifen in Premenopausal HR-positive Breast Cancer

Ovarian Function Suppression in Premenopausal Women with Early-Stage Breast Cancer

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