Department of Medical Oncology, National Cancer Research Institute, Largo Rosanna Benzi 10, Genoa, Italy.
Cancer Treat Rev. 2011 May;37(3):208-11. doi: 10.1016/j.ctrv.2010.07.007. Epub 2010 Aug 17.
Luteinising hormone releasing hormone agonists (LH-RHa) induce ovarian suppression in premenopausal women that is usually reversible on cessation of therapy. They act by binding to pituitary LH-RH receptors, resulting in down regulation of receptors and subsequent suppression of luteinising hormone and estradiol. LH-RHa are effective in the treatment of advanced breast cancer in premenopausal women but their role as adjuvant treatment of early breast cancer is still controversial. Approximately 60% of tumors in premenopausal women are hormone sensitive and these patients are candidates for hormonal treatment. Tamoxifen for 5 years is considered the standard endocrine therapy for all premenopausal women with hormone sensitive breast cancer. There is no definitive evidence of additional benefit associated with the use of LH-RHa administered as an alternative or in addition to tamoxifen. In this review we discuss available data on the role of LH-RHa alone or in combination with tamoxifen; on the role of LH-RHa in combination with aromatase inhibitors; and on the potential role of LH-RHa as a strategy to preserve ovarian function during adjuvant chemotherapy.
黄体生成素释放激素激动剂（LH-RHa）可诱导绝经前妇女的卵巢抑制，通常在停止治疗后可逆转。它们通过与垂体 LH-RH 受体结合而发挥作用，导致受体下调，随后抑制黄体生成素和雌二醇。LH-RHa 可有效治疗绝经前妇女的晚期乳腺癌，但它们作为早期乳腺癌辅助治疗的作用仍存在争议。大约 60%的绝经前妇女的肿瘤对激素敏感，这些患者是激素治疗的候选者。他莫昔芬治疗 5 年被认为是所有激素敏感型乳腺癌绝经前妇女的标准内分泌治疗。没有明确的证据表明使用 LH-RHa 替代或联合他莫昔芬治疗会带来额外的益处。在这篇综述中，我们讨论了 LH-RHa 单独或联合他莫昔芬的作用；LH-RHa 联合芳香化酶抑制剂的作用；以及 LH-RHa 作为在辅助化疗期间保留卵巢功能的策略的潜在作用。
