Effectiveness of a 6-Month 22.5-mg Leuprolide Acetate Depot Formulation With Tamoxifen for Postoperative Premenopausal Estrogen Suppression in Hormone Receptor-Positive Breast Cancer

Zhen-Yu Wu; Young-Jin Lee; Heejeong Kim; Jongwon Lee; Il Yong Chung; Jisun Kim; Saebyeol Lee; Byung-Ho Son; Sung-Bae Kim; Jae Ho Jeong; Gyungyub Gong; Sei-Hyun Ahn; BeomSeok Ko

doi:10.3389/fonc.2021.665426

Effectiveness of a 6-Month 22.5-mg Leuprolide Acetate Depot Formulation With Tamoxifen for Postoperative Premenopausal Estrogen Suppression in Hormone Receptor-Positive Breast Cancer

Front Oncol. 2021 Apr 28:11:665426. doi: 10.3389/fonc.2021.665426. eCollection 2021.

Authors

Affiliations

¹ Department of Breast Surgery, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China.
² Division of Breast Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
³ Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
⁴ Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.

Abstract

Background: In patients with hormone receptor-positive (HR+)/premenopausal breast cancer, luteinizing hormone-releasing hormone analogs (LHRHas) are used as standard endocrine treatment. Based on previous clinical studies, 1-month formulations are recommended in most breast cancer treatment guidelines, but long-acting formulations facilitate reductions in side effects and patient discomfort caused by frequent administration. However, few efficacy studies have been conducted on 6-month formulations. Therefore, this study aimed to evaluate the efficacy of 6-month formulations of LHRHas.

Methods: This retrospective study was conducted from January 2018 to December 2019 and involved premenopausal patients with HR+ breast cancer administered 6-month LHRHas as adjuvant treatment after surgery, and those previously administered chemotherapy or other LHRHa types were excluded. Patients' estradiol (E2) and follicle-stimulating hormone (FSH) levels were measured before surgery, and their E2 levels were also measured at 3, 6, 12, 18, and 24 months at periodic postsurgical examinations.

Results: A total of 228 patients were included, and the median patient age was 44 (range, 25-54) years. The mean serum E2 and FSH levels before surgery were 69.7 (range, 4-683) pg/mL and 7.3 (range, 0.4-88.9) mIU/mL, respectively, whereas the mean serum E2 level monitored at intervals during the 6-month LHRHa administration was 5.5 (range, 4.0-52) pg/mL. No women menstruated during the follow-up period after the LHRHas administration, and the E2 levels were less than 30 pg/mL in all patients except one.

Conclusions: The 6-month LHRHa formulation adequately suppressed ovarian function in premenopausal patients with HR+ breast cancer. This indicates that long-acting LHRHas can be effectively used for patient convenience and that there is high compliance with long-term use.

Keywords: breast neoplasms; endocrine therapy; hormonal receptor positive; leuprolide acetate; premenopausal.