Ovarian function suppression: To what extent is it necessary for premenopausal patients with operable hormone-sensitive breast cancer?
https://doi.org/10.17650/1994-4098-2015-11-3-35-42
Abstract
The use of tamoxifen is conventional adjuvant hormone therapy in premenopausal patients with receptor-positive breast cancer. Clinical trials demonstrating the benefits of ovarian function suppression as adjuvant treatment had an ambiguous interpretation. There is no scientific evidence favoring the empiric use of ovarian suppression for these patients. The members of the American Society of Clinical Oncology consider that ovarian ablation or suppression should be used during adjuvant hormone therapy only in certain cases. Irreversible ovarian function ablation may improve time to relapse, by simultaneously deteriorating the quality of life in patients. Irreversible fertility loss in the patients who have experienced breast cancer may become a leading stressful factor for these patients. Many investigators believe that chemotherapy-induced amenorrhea reduces the risk of recurrence. The paper discusses the usage of gonadotropin-releasing hormone agonists in combination with tamoxifen and aromatase inhibitors during adjuvant hormone therapy for early breast cancer. Whether ovarian suppression is needed during hormone therapy is considered, it is the reversible ovarian function suppression that must be standard treatment in premenopausal patients.
About the Author
P. V. Koposov
European Medical Cancer Research Center; 35 Shchepkin St., Moscow, 129090, Russia; EMC Medical School; 3А Oktyabrskaya St., Moscow, 119027, Russia
Russian Federation
Russian Federation
References
1. Partridge A.H., Pagani O., Abulkhair O. et al. First international consensus guidelines for breast cancer in young women (BCY1). Breast 2014;23:209–20.
2. Griggs J.J., Somerfield M.R., Anderson H. et al. American Society of Clinical Oncology endorsement of the сancer сare Ontario practice guideline on adjuvant ovarian ablation in the treatment of premenopausal women with early-stage invasive breast cancer. J Clin Oncol 2011;29:3939–42.
3. Burstein H.J., Temin S., Anderson H. et al. Adjuvant endocrine therapy for women with hormone receptor-positive breast cancer: American Society of Clinical Oncology clinical practice guideline focused update. J Clin Oncol 2014;32: 2255–69.
4. Tevaarwerk A.J., Wang M., Zhao F. et al. Phase III comparison of tamoxifen versus tamoxifen plus ovarian function suppression in premenopausal women with node-negative hormone receptor-positive breast cancer (E-3193, INT-0142): а trial of the Eastern Cooperative Oncology Group. J Clin Oncol 2014;32:3948–58.
5. Fisher B., Dignam J., Wolmark N. et al. Tamoxifen and chemotherapy for lymph nodenegative, estrogen receptor-positive breast cancer. J Natl Cancer Inst 1997;89:1673–82.
6. Davies C., Pan H., Godwin J. et al. Longterm effects of continuing adjuvant tamoxifen to 10 years versus stopping at 5 years after diagnosis of oestrogen receptor-positive breast cancer: ATLAS, a randomised trial. Lancet 2013;381:805–16.
7. Gray R.G. aTTom: Long-term effects of continuing adjuvant tamoxifen to 10 years versus stopping at years in 6.953 women with early breast cancer. J Clin Oncol 2013;31(Suppl):6s.
8. Goss P.E., Ingle J.N., Martino S. et al. Impact of premenopausal status at breast cancer diagnosis in women entered on the placebo-controlled NCIC CTG MA17 trial of extended adjuvant letrozole. Ann Oncol 2013;24:355–61.
9. Regan M.M., Pagani O., Fleming G.F. et al. Adjuvant treatment of premenopausal women with endocrine-responsive early breast cancer: design of the TEXT and SOFT trials. Breast 2013;22:1094–100.
10. Pagani O., Regan M.M., Walley B.A. et al. Adjuvant exemestane with ovarian suppression in premenopausal breast cancer. N Engl J Med 2014;371:107–18.
11. Francis P.A., Regan M.M., Fleming G.F. et al. 37th Annual San Antonio Breast Cancer Symposium. Dec 9–13, 2014. Abstr S3-08.
12. Regan M.M., Pagani O., Walley B. et al. Premenopausal endocrine-responsive earlybreast cancer: who receives chemotherapy? Ann Oncol 2008;19:1231–41.
13. Dowsett M., Cuzick J., Ingle J. et al. Metaanalysis of breast cancer outcomes in adjuvant trials of aromatase inhibitors versus tamoxifen. J Clin Oncol 2010;28:509–18.
14. Aebi S., Gelber S., Castiglione-Gertsch M. et al. Is chemotherapy alone adequate for young women with oestrogen-receptor-positive breast cancer? Lancet 2000;355:1869–74.
15. Goldhirsch A., Gelber R.D., Yothers G. et al. Adjuvant therapy for very young women with breast cancer: need for tailored treatments. J Natl Cancer Inst Monogr 2001;30:44–51.
16. Hackshaw A., Baum M., Fornander T. et al. Long-term effectiveness of adjuvant goserelin in premenopausal women with early breast cancer. J Natl Cancer Inst 2009;101:341–9.
17. Regan M.M., Neven P., Giobbie-Hurder A. et al. Assessment of letrozole and tamoxifen alone and in sequence for postmenopausal women with steroid hormone receptor-positive breast cancer: The BIG 1-98 randomised clinical trial at 8.1 years median follow-up. Lancet Oncol 2011;12:1101–8.
18. Gnant M., Mlineritsch B., Stoeger H. et al. Adjuvant endocrine therapy plus zoledronic acid in premenopausal women with early-stage breast cancer: 62-month follow-up from the ABCSG-12 randomised trial. Lancet Oncol 2011;12:631–41.
19. Pfeiler G., Königsberg R., Fesl C. et al. Impact of body mass index on the efficacy of endocrine therapy in premenopausal patients with breast cancer: аn analysis of the prospective ABCSG-12 trial. J Clin Oncol 2011;29:2653–9.
20. Jankowitz R., Puhalla S., Davidson N.E. Should we embrace or ablate our Urge to (ovarian) supress? J Clin Oncol 2014;32:3920–2.
21. Bernhard J., Luo W., Ribi K. et al. Patientreported endocrine symptoms, sexual functioning, and quality of life (QoL) in the IBCSG TEXT and SOFT trials: аdjuvant treatment with exemestane (E) plus ovarian function suppression (OFS) versus tamoxifen (T) plus OFS in premenopausal women with hormone receptor-positive (HR+) early breast cancer (BC). J Clin Oncol 2014;32(suppl):19s.
22. Consensus 14th St. Gallen Breast Cancer Conference 2015 Voting Results. http://www. oncoconferences.ch/mm/%5Cmm001/SGBCC_2015_Vienna__Consensus_Voting_ Results_Answers_in_-.pdf.
Review
For citations:
Koposov P.V. Ovarian function suppression: To what extent is it necessary for premenopausal patients with operable hormone-sensitive breast cancer? Tumors of female reproductive system. 2015;11(3):35-42. (In Russ.) https://doi.org/10.17650/1994-4098-2015-11-3-35-42
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