Aromatase inhibitors in male breast cancer: a pooled analysis

Abstract

Although several studies have shown the efficacy of third-generation aromatase inhibitors (AIs) in women with breast cancer, the role of such molecules remains elusive in male breast cancer patients. It is also unknown whether the addition of gonadotropin-releasing hormone (GnRH) analogues to AIs would be a superior strategy or not. This pooled analysis was conducted in accordance with the PRISMA guidelines. All studies that examined the efficacy of AIs in metastatic male breast cancer were considered eligible. Overall, 15 studies (105 cases) were eligible for this pooled analysis. The mean age of the study sample was 62.8 years. ER status was positive in all eligible cases. AI was given as first line in 61.5 % of cases. GnRH analogue was co-administered with AI in 37.1 % of cases (n = 39). CR, PR, SD and PD were achieved in 5.7, 23.8, 37.2 and 33.3 % of cases, respectively. The median PFS and OS were equal to 10.0 and 39.0 months, respectively. Co-administration of GnRH analogues was associated with more than threefold increase in rates of clinical benefit (OR = 3.37, 95 % CI 1.30-8.73) but did not seem to correlate with better PFS or OS. No statistically significant associations between the examined outcomes and the other parameters were noted. Available data suggest that AIs may potentially play a promising role in the optimal therapeutic strategy for metastatic male breast cancer patients. Especially, co-administration of AI with a GnRH analogue seems to increase the rate of clinical benefit and could be more effective, warranting further consideration.

Male patient with metastatic stage�IV breast cancer achieves complete remission on second line Abemaciclib, Fulvestrant and Leuprolide: A case report

“…Luteinizing hormones-releasing hormone agonists with or without anti-androgens have been shown to be effective in male breast cancer (34)(35)(36). Aromatase inhibitors have shown clinical activity in male breast cancer with increased clinical benefit observed with the addition of a GnRH analogue (37). Data regarding the role of Fulvestrant are limited.…”

Male breast cancer - a single center experience

“…As testosterone is a substrate for aromatase, further E2 suppression may be achieved with LHRH analogs. A recent pooled analysis of 105 male breast cancer cases demonstrated the effectiveness of the aforementioned strategy (a 3-fold increase in clinical benefit rate) (20), and in a smaller analysis of 60 patients, a survival benefit was observed following use of the combination strategy (21). However, a phase II trial investigating this further was closed prematurely due to poor accrual (22).…”

Serum Proteomic Signatures of Male Breast Cancer

“…Aromatase inhibitors (AIs) are extensively used for treating hormone receptor-positive, postmenopausal women with breast cancer as well as patients with metastatic MBC. However, analyses of male patients show that men do not respond equally well when treated with AIs, while AIs can only be recommended in male patients in conjunction with a luteinizing hormonereleasing hormone agonist (32). In this setting, their use in MBC is not substantiated by data deriving from prospective clinical trials but is based on similarities to postmenopausal FBC.…”