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6个月22.5毫克醋酸亮丙瑞林长效制剂联合他莫昔芬用于激素受体阳性乳腺癌绝经前患者术后雌激素抑制的疗效

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.

作者信息

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

机构信息

Department of Breast Surgery, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China.

Division of Breast Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.

出版信息

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

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.

摘要

背景

在激素受体阳性(HR+)/绝经前乳腺癌患者中,促黄体生成素释放激素类似物(LHRHas)被用作标准内分泌治疗。基于先前的临床研究,大多数乳腺癌治疗指南推荐使用1个月剂型,但长效剂型有助于减少频繁给药引起的副作用和患者不适。然而,针对6个月剂型的疗效研究较少。因此,本研究旨在评估LHRHas 6个月剂型的疗效。

方法

本回顾性研究于2018年1月至2019年12月进行,纳入绝经前HR+乳腺癌患者,这些患者在术后接受6个月LHRHas辅助治疗,排除先前接受过化疗或其他类型LHRHa的患者。在手术前测量患者的雌二醇(E2)和促卵泡生成素(FSH)水平,并在术后定期检查的3、6、12、18和24个月测量其E2水平。

结果

共纳入228例患者,患者中位年龄为44岁(范围25 - 54岁)。手术前血清E2和FSH的平均水平分别为69.7(范围4 - 683)pg/mL和7.3(范围0.4 - 88.9)mIU/mL,而在6个月LHRHa给药期间定期监测的血清E2平均水平为5.5(范围4.0 - 52)pg/mL。LHRHas给药后的随访期间无女性月经来潮,除1例患者外,所有患者的E2水平均低于30 pg/mL。

结论

6个月LHRHa剂型能充分抑制绝经前HR+乳腺癌患者的卵巢功能。这表明长效LHRHas可有效提高患者便利性,且长期使用依从性高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/571e/8113853/9b76f0830ea4/fonc-11-665426-g001.jpg

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