Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Breast Oncology, Peking University Cancer Hospital & Institute, Beijing, 100142, China.
Breast Cancer Res Treat. 2024 Aug;206(3):543-550. doi: 10.1007/s10549-024-07323-9. Epub 2024 May 6.
This study evaluated the effectiveness of ovarian function suppression (OFS) of various gonadotropin-releasing hormone agonists (GnRHa) combined with aromatase inhibitors (AI) in premenopausal patients with hormone receptor-positive (HR-positive) breast cancer. Potential risk factors associated with insufficient OFS were analyzed.
Premenopausal HR-positive breast cancer patients who had received AI with GnRHa were studied retrospectively. Patients were divided into different groups according to monthly or trimonthly GnRHa schedules they received, and the effectiveness of OFS was compared between groups. Insufficient OFS was defined as at least one instance of estradiol ≥ 30 pg/ml. Patient data was gathered from medical records for this comparison.
Of the 264 patients enrolled in this study, 117 were administered 3.6 mg of goserelin monthly (goserelin 1 M group), 63 received 3.75 mg of leuprorelin monthly (leuprorelin 1 M group) and 84 were given 11.25 mg of leuprorelin every three months (leuprorelin 3 M group). Overall, 7.20% experienced insufficient OFS. The incidence rates in the three GnRHa depot groups were 7.69%, 6.35%, and 7.14%, respectively, without a significant statistical difference (P = 0.900). Notably, younger patients exhibited a higher likelihood of insufficient OFS [OR = 0.900, 95%CI (0.824-0.982), P = 0.018].
Insufficient OFS remains a concern during GnRHa and AI treatment. The effectiveness of the three GnRHa depots commonly used in China seems comparable. Younger patients face a heightened risk of insufficient OFS.
本研究评估了各种促性腺激素释放激素激动剂（GnRHa）联合芳香化酶抑制剂（AI）对激素受体阳性（HR 阳性）乳腺癌绝经前患者卵巢功能抑制（OFS）的有效性。分析了与 OFS 不足相关的潜在危险因素。
回顾性研究接受 AI 联合 GnRHa 治疗的绝经前 HR 阳性乳腺癌患者。根据患者接受的每月或每三月 GnRHa 方案将患者分为不同组，并比较组间 OFS 的有效性。OFS 不足定义为至少有一次雌二醇≥30pg/ml。本比较从病历中收集患者数据。
本研究共纳入 264 例患者，其中 117 例接受 3.6mg 戈舍瑞林每月（戈舍瑞林 1M 组），63 例接受 3.75mg 亮丙瑞林每月（亮丙瑞林 1M 组），84 例每三月给予 11.25mg 亮丙瑞林（亮丙瑞林 3M 组）。总体而言，有 7.20%的患者出现 OFS 不足。三组 GnRHa 制剂组的发生率分别为 7.69%、6.35%和 7.14%，无统计学差异（P=0.900）。值得注意的是，年轻患者出现 OFS 不足的可能性更高[OR=0.900，95%CI（0.824-0.982），P=0.018]。
在 GnRHa 和 AI 治疗期间，OFS 不足仍然是一个问题。中国常用的三种 GnRHa 制剂的疗效似乎相当。年轻患者面临更高的 OFS 不足风险。
