Change in Estradiol Levels among Premenopausal Patients with Breast Cancer Treated Using Leuprolide Acetate 11.25 Milligrams 3-Month Depot and Tamoxifen

Abstract

The combination of luteinizing hormone-releasing hormone analogs (LHRHa) with tamoxifen is used as a standard postoperative adjuvant therapy in patients with hormone receptor-positive/premenopausal breast cancer. Long-acting LHRHa formulations offer advantages in terms of patient convenience. However, data on the effectiveness of the 3-month (3M) acting formulation are still insufficient. This study was performed on patients who received the 3M LHRHa after surgery. The serum estradiol (E2) and follicle-stimulating hormone levels were measured before surgery, and periodically after surgery. In total, 318 patients were included in the study and analyzed. The mean E2 level before surgery was 63.7 pg/mL, while the mean E2 level during the administration of 3M LHRHa was 4.9 pg/mL. None of the patients were menstruating and had E2 values above 30.0 pg/mL. It is thought that the 3M LHRHa formulation can suppress the ovarian function effectively and be safely used to improve compliance.

Effectiveness of gonadotropin-releasing hormone agonists for ovarian function suppression in premenopausal patients with hormone receptor-positive breast cancer: a retrospective single-center real-world study

“…The TABLE study [ 26 ] was a randomized phase III trial comparing 3-monthly depot GnRHa with chemotherapy, in which E2 < 30 pg/ml was also used as the menopausal threshold. Not coincidentally, Lee et al and Wu et al [ 27 , 28 ] chose this criterion when studying the effectiveness of 3-monthly and 6-monthly GnRHa formulations combined with tamoxifen therapy, respectively. These differences in E2 cutoff levels for postmenopausal status, ranging from E2 < 30 pg/ml to E2 < 40 pg/ml, highlight the lack of a standardized approach in measuring and interpreting hormone suppression efficacy in different studies.…”

Leuprolide Acetate Treatment for Ovarian Cysts in Breast Cancer Patients Under Tamoxifen Therapy

“…Utilization of GnRH agonists in addition to postoperative tamoxifen treatment in patients with premenopausal breast cancer for two years increases the disease-free survival (25,26). Owing to their positive effect on survival, GnRH agonists are frequently used in adjuvant therapy.…”

Ovarian Function Suppression With Luteinizing Hormone-Releasing Hormone Agonists for the Treatment of Hormone Receptor-Positive Early Breast Cancer in Premenopausal Women

“…In 167 premenopausal patients with HR+ breast cancer randomized to receive either 11.25 mg leuprorelin 3-monthly or 22.5 mg leuprorelin 6-monthly, the rate of E2 suppression (to ≤ 30 pg/mL) was found to be 1.2% higher in the group using the longer-acting formulation (3-monthly formulation 96.4%; 6-monthly formulation 97.6%) without significant differences in adverse events ( 89 ). In a retrospective study by Lee and colleagues of 318 women who had previously undergone surgery for breast cancer, post-surgery treatment with 3-monthly leuprorelin acetate (11.25 mg) successfully reduced E2 levels below 30 pg/mL (mean: 4.9 pg/mL) in all patients demonstrating the effectiveness of this formulation ( 90 ).…”