Different dosage forms of gonadotropin-releasing hormone agonist with endocrine therapy in premenopausal hormone receptor-positive breast cancer.

IF 9.9 1区医学 Q1 ONCOLOGY JNCI Journal of the National Cancer Institute Pub Date : 2024-10-01 DOI:10.1093/jnci/djae115

Jinna Lin, Yiye Ouyang, Yudong Li, Liang Jin, Shunying Li, Yujie Liu, Yaping Yang, Qianfeng Shi, Mengdi Zhu, Zijie Cai, Jingru Wang, Nianqiu Liu, Yue Hu, Zongqi Wu, Mengzi Wu, Lok Lam Wong, Xiaoting Jiang, Qi Wang, Wang Yang, Qiang Liu

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Abstract

Background: Despite the wide use of a 3-month gonadotropin-releasing hormone (GnRH) agonist for ovarian function suppression in premenopausal breast cancer patients, it remains unclear whether it is as effective and safe as a 1-month GnRH agonist regimen when combined with selective estrogen receptor modulators or aromatase inhibitors, especially in younger patients.

Methods: This retrospective cohort study included 1109 premenopausal hormone receptor-positive breast cancer patients treated with GnRH agonist plus selective estrogen receptor modulator or aromatase inhibitor. The estradiol (E2) inhibition rate within 1-24 months after treatment with 1-month or 3-month GnRH agonist in cohorts and different subgroups was analyzed.

Results: Following 1:1 propensity score matching, 950 patients with a mean age of 39 years and a median follow-up of 46 months were included. Both the 1-month and 3-month groups achieved more than 90% E2 inhibition within 24 months (94.53% vs 92.84%, with a 95% confidence interval for the difference ranging from -4.78% to 1.41%), confirming the noninferiority of 3-month GnRH agonist. Both 1-month and 3-month GnRH agonist rapidly and consistently reduced E2 levels. Of the patients, 60 (6.3%) experienced incomplete ovarian function suppression, with similar rates in the 1-month and 3-month groups (5.5% vs 7.2%). Incomplete ovarian function suppression mainly occurred within the first 12 months, with age younger than 40 years and no prior chemotherapy being the risk factors. Similar disease-free survival and overall survival were found in the 1-month and 3-month groups and in patients with complete and incomplete ovarian function suppression (P > .05).

Conclusions: The ovarian function suppression with 3-month GnRH agonist was not inferior to that with 1-month GnRH agonist, regardless of age or combination with a selective estrogen receptor modulator or an aromatase inhibitor.

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绝经前激素受体阳性乳腺癌患者在接受内分泌治疗时使用不同剂量的 GnRHa。

背景：尽管绝经前乳腺癌患者广泛使用为期三个月的促性腺激素释放激素激动剂（3M GnRHa）进行卵巢功能抑制（OFS），但仍不清楚在与选择性雌激素受体调节剂（SERMs）或芳香化酶抑制剂（AIs）联合使用时，其疗效和安全性是否与为期一个月的 GnRHa 方案（1M GnRHa）相同，尤其是在年轻患者中：这项回顾性队列研究纳入了1109例绝经前激素受体阳性（HR+）乳腺癌患者，这些患者接受了GnRHa加SERM或AI治疗。研究分析了组群和不同亚组在接受1M或3M GnRHa治疗后1-24个月内的雌二醇（E2）抑制率：经过 1:1 倾向评分匹配，共纳入 950 名患者，他们的平均年龄为 39 岁，中位随访时间为 46 个月。1M 组和 3M 组在 24 个月内的 E2 抑制率均大于 90%（94.53% vs 92.84%，95% CI (-4.78%, 1.41%)），证实了 3M GnRHa 的非劣效性。1M 和 3M GnRHa 都能迅速、持续地降低 E2 水平。60例（6.3%）患者出现不完全卵巢功能抑制（iOFS），1M组和3M组的发生率相似（5.5% vs 7.2%）：结论：使用 3M GnRHa 的 OFS 并不比使用 1M GnRHa 的 OFS 差，与年龄、与 SERM 或 AI 的组合无关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

JNCI Journal of the National Cancer Institute 医学-肿瘤学

CiteScore

17.00

自引率

2.90%

发文量

203

审稿时长

4-8 weeks

期刊介绍： The Journal of the National Cancer Institute is a reputable publication that undergoes a peer-review process. It is available in both print (ISSN: 0027-8874) and online (ISSN: 1460-2105) formats, with 12 issues released annually. The journal's primary aim is to disseminate innovative and important discoveries in the field of cancer research, with specific emphasis on clinical, epidemiologic, behavioral, and health outcomes studies. Authors are encouraged to submit reviews, minireviews, and commentaries. The journal ensures that submitted manuscripts undergo a rigorous and expedited review to publish scientifically and medically significant findings in a timely manner.