Di Lauro Luigi, Pizzuti Laura, Barba Maddalena, Sergi Domenico, Sperduti Isabella, Mottolese Marcella, Amoreo Carla Azzurra, Belli Franca, Vici Patrizia, Speirs Valerie, Santini Daniele, De Maria Ruggero, Maugeri-Saccà Marcello
Division of Medical Oncology B, "Regina Elena" National Cancer Institute, Via Elio Chianesi 53, 00144, Rome, Italy.
Scientific Direction, "Regina Elena" National Cancer Institute, Via Elio Chianesi 53, 00144, Rome, Italy.
J Hematol Oncol. 2015 May 17;8:53. doi: 10.1186/s13045-015-0147-z.
Male breast cancer is a rare malignancy. Despite the lack of prospectively generated data from trials in either the adjuvant or metastatic setting, patients are commonly treated with hormone therapies. Much controversy exists over the use of gonadotropin-releasing hormone analogues in metastatic male breast cancer patients. We conducted this study to provide more concrete ground on the use of gonadotropin-releasing hormone analogues in this setting.
We herein present results from a pooled analysis including 60 metastatic male breast cancer patients treated with either an aromatase inhibitor or cyproterone acetate as a monotherapy (23 patients) or combined with a gonadotropin-releasing hormone analogue (37 patients).
Overall response rate was 43.5% in patients treated with monotherapy and 51.3% with combination therapy (p = 0.6). Survival outcomes favored combination therapy in terms of median progression-free survival (11.6 months versus 6 months; p = 0.05), 1-year progression-free survival rate (43.2% versus 21.7%; p = 0.05), median overall survival (29.7 months versus 22 months; p = 0.05), and 2-year survival rate (64.9% versus 43.5%; p = 0.05).
In metastatic male breast cancer patients, the combined use of gonadotropin-releasing hormone analogues and aromatase inhibitors or antiandrogens seems to be associated with greater efficacy, particularly in terms of survival outcomes, compared with monotherapy. Collectively, these results encourage considering these agents in the metastatic setting.
男性乳腺癌是一种罕见的恶性肿瘤。尽管在辅助治疗或转移性疾病治疗方面缺乏前瞻性试验数据，但患者通常接受激素治疗。对于转移性男性乳腺癌患者使用促性腺激素释放激素类似物存在很多争议。我们开展这项研究是为了为在这种情况下使用促性腺激素释放激素类似物提供更具体的依据。
我们在此展示一项汇总分析的结果，该分析纳入了60例转移性男性乳腺癌患者，这些患者接受了芳香化酶抑制剂或醋酸环丙孕酮单药治疗（23例患者）或联合促性腺激素释放激素类似物治疗（37例患者）。
单药治疗患者的总体缓解率为43.5%，联合治疗患者为51.3%（p = 0.6）。在中位无进展生存期（11.6个月对6个月；p = 0.05）、1年无进展生存率（43.2%对21.7%；p = 0.05）、中位总生存期（29.7个月对22个月；p = 0.05）和2年生存率（64.9%对43.5%；p = 0.05）方面，生存结果支持联合治疗。
在转移性男性乳腺癌患者中，与单药治疗相比，促性腺激素释放激素类似物与芳香化酶抑制剂或抗雄激素联合使用似乎疗效更佳，尤其是在生存结果方面。总体而言，这些结果鼓励在转移性疾病治疗中考虑使用这些药物。
