When used in combination with chemotherapy and tamoxifen, luteinizing hormone-releasing hormone (LHRH) agonists are effective in treating hormone-receptor-positive breast cancer in premenopausal women, according to a meta-analysis published in the May 19 issue of the Lancet.
Jack Cuzick, PhD, of the University of London in the United Kingdom, and colleagues in the LHRH Agonists in Early Breast Cancer Overview group reviewed data from 16 trials comprising 11,906 premenopausal women with early breast cancer.
Used alone, the hormone agonists did not reduce recurrence or death after recurrence, but when used in combination with tamoxifen, chemotherapy, or both, the agonists reduced recurrence by 12.7% and death after recurrence by 15.1%. The LHRH agonists had no effect on hormone-receptor-negative breast cancer.
Chemotherapy followed by tamoxifen should remain the standard approach for women with higher-risk disease, but the addition of LHRH agonists for premenopausal women is worth considering, according to the authors of an accompanying editorial. "A century of research has taught us much about endocrine therapy for breast cancer, but the most important lessons about adjuvant ovarian suppression will be learnt over the next decade," they write.
LHRH-agonists in Early Breast Cancer Overview group, Cuzick J, et al. Use of luteinising-hormone-releasing hormone agonists as adjuvant treatment in premenopausal patients with hormone-receptor-positive breast cancer: a meta-analysis of individual patient data from randomised adjuvant trials. Lancet. 2007;369:1711-1723.