Estrogen levels in young women with hormone receptor-positive breast cancer on ovarian function suppression therapy.

IF 6.5 2区医学 Q1 ONCOLOGY

NPJ Breast Cancer Pub Date : 2024-08-01 DOI:10.1038/s41523-024-00680-0

Megan E Tesch, Yue Zheng, Shoshana M Rosenberg, Philip D Poorvu, Kathryn J Ruddy, Rulla Tamimi, Lidia Schapira, Jeffrey Peppercorn, Virginia Borges, Steven E Come, Craig Snow, Shalender Bhasin, Ann H Partridge

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Abstract

Ovarian function suppression (OFS) benefits young women with hormone receptor (HR)-positive breast cancer but they are at risk for ovarian function breakthrough. We assessed endocrine effects of gonadotropin-releasing hormone agonist (GnRHa) treatment in a prospective cohort of patients aged ≤ 40 years with HR-positive breast cancer. Plasma estradiol (E2), estrone, and follicule-stimulating hormone (FSH) levels were measured from blood samples drawn 1 and 4 years after diagnosis. Patient characteristics, invasive breast cancer-free survival (iBCFS), and overall survival (OS) were compared between those with and without E2 > 2.72 pg/mL during GnRHa treatment. Among eligible patients, 54.7% (46/84) and 60% (15/25) had E2 > 2.72 pg/mL at 1 and 4 years, respectively. Factors associated with E2 > 2.72 pg/mL at 1 year were no prior chemotherapy (P = 0.045) and tamoxifen use (P = 0.009). After a median follow-up of 7 years, among patients with stage I-III breast cancer (N = 74), iBCFS events were seen in 6 (8.1%) with E2 > 2.72 pg/mL and 5 (6.8%) with E2 ≤ 2.72 pg/mL (P = 0.893). Among patients with de novo metastatic breast cancer (N = 12), 6 (50%) with E2 > 2.72 pg/mL and 3 (25%) with E2 ≤ 2.72 pg/mL died during follow-up (P = 0.052). Larger studies exploring the clinical implications of incomplete E2 suppression by GnRHa are needed to ensure optimal OFS treatment strategies are being employed for this population.

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接受卵巢功能抑制疗法的激素受体阳性乳腺癌年轻女性的雌激素水平。

卵巢功能抑制（OFS）可使激素受体（HR）阳性乳腺癌年轻女性获益，但她们面临卵巢功能受损的风险。我们评估了促性腺激素释放激素激动剂（GnRHa）治疗对前瞻性队列中年龄小于 40 岁的 HR 阳性乳腺癌患者内分泌的影响。在确诊后1年和4年抽取的血样中测量了血浆雌二醇（E2）、雌酮和促卵泡激素（FSH）水平。比较了在接受 GnRHa 治疗期间 E2 > 2.72 pg/mL 和 E2 不 > 2.72 pg/mL 患者的特征、无浸润性乳腺癌生存率（iBCFS）和总生存率（OS）。在符合条件的患者中，分别有54.7%（46/84）和60%（15/25）的患者在1年和4年后E2>2.72 pg/mL。1年时E2>2.72 pg/mL的相关因素包括未接受过化疗（P = 0.045）和使用他莫昔芬（P = 0.009）。中位随访 7 年后，在 I-III 期乳腺癌患者（74 人）中，E2 > 2.72 pg/mL 的患者有 6 人（8.1%）发生 iBCFS 事件，E2 ≤ 2.72 pg/mL 的患者有 5 人（6.8%）发生 iBCFS 事件（P = 0.893）。在新发转移性乳腺癌患者（12 人）中，6 人（50%）E2 > 2.72 pg/mL，3 人（25%）E2 ≤ 2.72 pg/mL 在随访期间死亡（P = 0.052）。需要进行更大规模的研究，探讨 GnRHa 不完全抑制 E2 的临床影响，以确保对这一人群采用最佳的 OFS 治疗策略。

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

NPJ Breast Cancer Medicine-Pharmacology (medical)

CiteScore

10.10

自引率

1.70%

发文量

122

审稿时长

9 weeks

期刊介绍： npj Breast Cancer publishes original research articles, reviews, brief correspondence, meeting reports, editorial summaries and hypothesis generating observations which could be unexplained or preliminary findings from experiments, novel ideas, or the framing of new questions that need to be solved. Featured topics of the journal include imaging, immunotherapy, molecular classification of disease, mechanism-based therapies largely targeting signal transduction pathways, carcinogenesis including hereditary susceptibility and molecular epidemiology, survivorship issues including long-term toxicities of treatment and secondary neoplasm occurrence, the biophysics of cancer, mechanisms of metastasis and their perturbation, and studies of the tumor microenvironment.