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• W2809023879 startingPage "974" @default.
• W2809023879 abstract "Abstract There is growing interest in the endocrine treatment (ET) of premenopausal women with hormone receptor positive (HR+) metastatic breast cancer (MBC). This review summarizes available data on endocrine therapy for this patient subset and aims to define the most appropriate treatment approach. The combination of luteinizing hormone-releasing hormone (LHRH) agonists plus tamoxifen seems effective and safe and is considered as being superior to either approach alone; still, single-agent therapy remains an acceptable treatment option. Due to their mechanism of action, aromatase inhibitors alone are not suitable for the treatment of premenopausal patients, but the combination with LHRH agonists may result in excellent disease control. Fulvestrant, in conjunction with LHRH agonists, also yields interesting results regarding clinical benefit rate and time to progression; currently, other orally available selective estrogen receptor downregulators are under clinical evaluation. Recently, targeted drugs have been added to ET in order to reverse endocrine resistance, but only limited information regarding their activity in premenopausal patients is available. The cyclin dependent kinase 4 and 6 inhibitor palbociclib when combined with fulvestrant and LHRH agonists was shown to prolong progression-free survival over endocrine therapy alone in pretreated patients; similar results were obtained with the addition of abemacicilib or ribociclib to endocrine therapy. Currently, activity of the mammalian target of rapamycin inhibitor everolimus in combination with letrozole and goserelin is under assessment in premenopausal patients after progression on tamoxifen (MIRACLE trial). Implications for Practice This review provides clinicians with an overview on the available data regarding endocrine treatment of hormone receptor positive (HR+) metastatic breast cancer (MBC) in premenopausal women and summarizes the treatment options available in routine clinical practice. Knowledge of an up-to-date therapeutic approach in women with premenopausal HR+ MBC will lead to better disease management, thereby improving disease control and quality of life while minimizing side effects." @default.
• W2809023879 created "2018-06-29" @default.
• W2809023879 creator A5071435030 @default.
• W2809023879 creator A5077307794 @default.
• W2809023879 creator A5087559224 @default.
• W2809023879 date "2018-06-22" @default.
• W2809023879 modified "2023-10-17" @default.
• W2809023879 title "Endocrine Therapy in Premenopausal Hormone Receptor Positive/Human Epidermal Growth Receptor 2 Negative Metastatic Breast Cancer: Between Guidelines and Literature" @default.
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• W2809023879 doi "https://doi.org/10.1634/theoncologist.2018-0077" @default.
• W2809023879 hasPubMedCentralId "https://www.ncbi.nlm.nih.gov/pmc/articles/6156183" @default.
• W2809023879 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/29934412" @default.
• W2809023879 hasPublicationYear "2018" @default.
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