PURPOSE: To compare the endocrine effects of 6 months of adjuvant treatment with letrozole + triptorelin or tamoxifen + triptorelin in premenopausal patients with early breast cancer within an ongoing phase 3 trial (Hormonal Adjuvant Treatment Bone Effects study). PATIENTS AND METHODS: Prospectively collected hormonal data were available for 81 premenopausal women, of whom 30 were assigned to receivetamoxifen + triptorelin and 51 were assigned letrozole + triptorelin +/- zoledronate. Serum 17-beta-estradiol (E2), follicle-stimulating hormone (FSH), luteinizing hormone (LH), Delta4-androstenedione, testosterone, dehydroepiandrosterone-sulfate, progesterone, adrenocorticotropic hormone (ACTH), and cortisol were measured at baseline and after 6 months of treatment. For each hormone, 6-month values were compared between treatment groups by the Wilcoxon-Mann-Whitney exact test. RESULTS:Median age was 44 years for both groups of patients. Letrozole + triptorelin (+/- zoledronate) induced a stronger suppression of median E2 serum levels (P = .0008), LH levels (P = .0005), and cortisol serum levels (P < .0001) compared with tamoxifen + triptorelin. Median FSH serum levels were suppressed in both groups, but such suppression was lower among patients receiving letrozole, who showed significantly higher median FSH serum levels (P < .0001). No significant differences were observed for testosterone, progesterone, ACTH, androstenedione, and dehydroepiandrosterone between the two groups of patients. CONCLUSION:Letrozole in combination with triptorelin induces a more intense estrogen suppression than tamoxifen + triptorelin in premenopausal patients with early breast cancer.
RCT Entities:
PURPOSE: To compare the endocrine effects of 6 months of adjuvant treatment with letrozole + triptorelin or tamoxifen + triptorelin in premenopausal patients with early breast cancer within an ongoing phase 3 trial (Hormonal Adjuvant Treatment Bone Effects study). PATIENTS AND METHODS: Prospectively collected hormonal data were available for 81 premenopausal women, of whom 30 were assigned to receive tamoxifen + triptorelin and 51 were assigned letrozole + triptorelin +/- zoledronate. Serum 17-beta-estradiol (E2), follicle-stimulating hormone (FSH), luteinizing hormone (LH), Delta4-androstenedione, testosterone, dehydroepiandrosterone-sulfate, progesterone, adrenocorticotropic hormone (ACTH), and cortisol were measured at baseline and after 6 months of treatment. For each hormone, 6-month values were compared between treatment groups by the Wilcoxon-Mann-Whitney exact test. RESULTS: Median age was 44 years for both groups of patients. Letrozole + triptorelin (+/- zoledronate) induced a stronger suppression of median E2 serum levels (P = .0008), LH levels (P = .0005), and cortisol serum levels (P < .0001) compared with tamoxifen + triptorelin. Median FSH serum levels were suppressed in both groups, but such suppression was lower among patients receiving letrozole, who showed significantly higher median FSH serum levels (P < .0001). No significant differences were observed for testosterone, progesterone, ACTH, androstenedione, and dehydroepiandrosterone between the two groups of patients. CONCLUSION:Letrozole in combination with triptorelin induces a more intense estrogen suppression than tamoxifen + triptorelin in premenopausal patients with early breast cancer.
Authors: Meritxell Bellet; Kathryn P Gray; Prudence A Francis; István Láng; Eva Ciruelos; Ana Lluch; Miguel Angel Climent; Gustavo Catalán; Antoni Avella; Uriel Bohn; Antonio González-Martin; Roser Ferrer; Roberto Catalán; Analía Azaro; Agnita Rajasekaran; Josefa Morales; Josep Vázquez; Gini F Fleming; Karen N Price; Meredith M Regan Journal: J Clin Oncol Date: 2016-01-04 Impact factor: 44.544
Authors: Kienan I Savage; Kyle B Matchett; Eliana M Barros; Kevin M Cooper; Gareth W Irwin; Julia J Gorski; Katy S Orr; Jekaterina Vohhodina; Joy N Kavanagh; Angelina F Madden; Alexander Powell; Lorenzo Manti; Simon S McDade; Ben Ho Park; Kevin M Prise; Stuart A McIntosh; Manuel Salto-Tellez; Derek J Richard; Christopher T Elliott; D Paul Harkin Journal: Cancer Res Date: 2014-03-17 Impact factor: 12.701