Spotlight on triptorelin in the treatment of premenopausal women with early-stage breast cancer

Abstract

Endocrine treatment represents the cornerstone of endocrine-sensitive premenopausal early breast cancer. The estrogen blockade plays a leading role in the therapeutic management of hormone receptor-positive breast cancer together with surgery, radiotherapy, and selective antiestrogen treatments. For several years, selective estrogen receptor modulators, such as tamoxifen, have represented the mainstay of therapy. The role of amenorrhea has been extensively elucidated in the past year: the benefit observed with chemotherapy-induced amenorrhea has strengthened its therapeutic role. Luteinizing hormone-releasing hormone (LHRH) has been introduced in oncology practice to induce amenorrhea in order to increase the advantage obtained from endocrine treatment. Triptorelin is one of the most widely used LHRH analogs currently available in clinical practice. It was recently investigated in two major clinical trials that studied the role of complete estrogen blockade in the premenopausal setting. Both showed the clinical benefit due to ovarian suppression treatment, primarily in high-risk patients. Furthermore, triptorelin and other LHRH analogs have recently been investigated in the attempt to preserve the ovarian function in young patients. The medical treatment of early breast cancer is always evolving in the effort to search for safe and efficacious treatments. The role of LHRH analogs is actually well recognized as contributing to the improvement of the medical treatment of premenopausal women with early breast cancer.

Keywords:

• adjuvant
• hormone therapy
• LHRH
• amenorrhea

Acknowledgments

This review has been conducted following the Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 (updated March 2011). The objective of this review was to specifically evaluate the role of LHRH analog triptorelin in the management of early breast cancer. The types of studies selected in this review were as follows: randomized controlled clinical trials and their related updates, meta-analyses, and relevant published studies concerning the role of triptorelin in the breast cancer treatment. Also, the published trials and their related updates, concerning the role of triptorelin, and other LHRH analogs were selected to evaluate its role in the preservation of ovarian function in the early breast cancer setting.

Author contributions

All authors contributed toward data analysis, drafting and critically revising the paper and agree to be accountable for all aspects of the work.

Disclosure

The authors report no conflicts of interest in this work.