Investigator Perspectives

Vasomotor symptoms (VMS) are among the most clinically consequential adverse events of endocrine therapy in patients with hormone receptor–positive breast cancer, affecting the majority of treated patients and contributing to suboptimal treatment adherence. In this video series, Carmine Valenza, MD, MPH, PhD(c), reviews the neurobiology underlying VMS, explaining how estrogen deprivation leads to hyperactivation of hypothalamic KNDy neurons and how dual NK1/NK3 receptor antagonism with elinzanetant (Lynkuet) targets this pathway through a nonhormonal mechanism considered safe for use in patients with breast cancer.

This educational program features Genevieve Neal-Perry, MD, PhD, discussing the disproportionate burden of vasomotor symptoms among African American women and the need for equitable, evidence-based menopause care. Across multiple segments, Neal-Perry reviews the design and pooled efficacy data from the OASIS 1 and 2 trials, demonstrating that elinzanetant (Lynkuet) significantly reduces hot flash frequency and severity, improves sleep, and enhances quality of life across racial subgroups, with rapid onset of benefit and a favorable safety profile.

Fiona C. Baker, PhD, discusses the clinical presentation and diagnosis of vasomotor symptoms, interprets new phase 3 data on elinzanetant, and provides guidance to help clinicians confidently manage VMS and navigate emerging non-hormonal treatment options.

E. Michael Lewiecki, MD, discusses how menopause significantly impacts bone health through increased bone remodeling and loss, while exploring promising new neurokinin-targeted therapies like elinzanetant that may simultaneously treat vasomotor symptoms and provide skeletal benefits, as demonstrated in the OASIS-3 trial's subanalysis showing improved bone mineral density, reduced bone turnover markers, and favorable body composition changes compared with placebo.

A panelist highlights that new nonhormonal treatments show promising, well-tolerated relief of persistent vasomotor symptoms (VMS) in patients with hormone receptor–positive breast cancer receiving endocrine therapy, improving quality of life and adherence while ongoing research addresses long-term safety and underserved populations.