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Review
. 2024 Jul 25;31(8):4209-4224.
doi: 10.3390/curroncol31080314.

An Overview of Long-Acting GnRH Agonists in Premenopausal Breast Cancer Patients: Survivorship Challenges and Management

Nathalie LeVasseur  1 , Mita Manna  2 , Katarzyna J Jerzak  3
Affiliations
Review

An Overview of Long-Acting GnRH Agonists in Premenopausal Breast Cancer Patients: Survivorship Challenges and Management

Nathalie LeVasseur et al. Curr Oncol. .

Abstract

Managing breast cancer in premenopausal women poses unique challenges due to its considerable effect on both morbidity and mortality. Goserelin, a gonadotropin-releasing hormone agonist, has emerged among the various modalities as a preferred option for ovarian function suppression, owing to its efficacy in reducing ovarian estrogen production in premenopausal women with hormone receptor-positive breast cancer. Recent studies have affirmed the efficacy and safety of long-acting (LA) goserelin 10.8 mg every 12 weeks, offering comparable outcomes to monthly injections. This flexibility enables personalized treatment approaches, potentially enhancing patient satisfaction. Off-label utilization of goserelin LA surged during the coronavirus disease pandemic, prompting initiatives to broaden its use for breast cancer treatment. Switching to goserelin LA can streamline treatment, boost adherence, and optimize resource utilization. With the recent approval of goserelin 10.8 mg LA by Health Canada on 6 May 2024, for use in breast cancer, Canada is the latest to join over 60 countries worldwide to expand the accepted indications for goserelin LA and ensure its availability to potentially enhance healthcare delivery, patient care, and breast cancer outcomes. Goserelin LA offers premenopausal patients a means to more effectively manage the constraints imposed by breast cancer treatment and its impact on survivorship.

Keywords: GnRH; LHRH agonist; breast cancer adjuvant therapy; goserelin; hormone receptor-positive breast cancer; long-acting; ovarian function suppression; premenopausal; survivorship.

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Conflict of interest statement

N.L. reports receiving honoraria for participation in advisory boards from Gilead, Knight, Lilly, Novartis, Pfizer, Roche, Seagen, and TerSera; receiving speaker honoraria from AstraZeneca, Gilead Sciences, Lilly, Merck, Novartis, and Seagen; and research funds to their institution from Abbvie, Exact Sciences, Gilead, Lilly, Pfizer and Roche. M.M. reports receiving honoraria for participation in advisory boards from Gilead Sciences, Eli Lilly, Novartis, Merck, Pfizer, Daichii Sankyo, AstraZeneca, Roche, and Seagen; receiving speaker honoraria from AstraZeneca, Gilead Sciences, Merck, Pfizer, Eli Lilly, Novartis, and Seagen; and receiving grants/research support from AstraZeneca. K.J.J. reports participation in advisory boards and/or speaker honoraria/consultant fees from Amgen, AstraZeneca, Apo Biologix, Daiichy Sankyo, Eli Lilly, Esai, Genomic Health, Gilead Sciences, Knight Therapeutics, Merck, Myriad Genetics Inc, Pfizer, Roche, Seagen, Novartis, Viatris and Organon; and receiving grants/research support from AstraZeneca, Eli Lilly, and Seagen. The authors were not compensated for their involvement in this manuscript. The funders had initial discussions with N.L. regarding the conceptualization of the manuscript; they had no role in the design of the outline, the references selected, the writing of the manuscript, or in the decision to publish the article.

Figures

Figure 1
Figure 1
Definitions of pre-, peri-, and post-menopausal [10,11,15,24,25,26]. E2, estradiol; FSH, follicle stimulating hormone; OFSET, Ovarian Function Suppression plus Endocrine Therapy. * Varies based on health and socioeconomic factors (e.g., oral contraceptive, alcohol, smoking, diet, physical activity, weight, ethnicity, education, employment, environmental exposure). † Due to an intrauterine device or prior uterine ablation.
Figure 2
Figure 2
Survivorship challenges faced by premenopausal women with breast cancer [12,31,32,33,34,35,36,37,38]. PTSD, posttraumatic stress disorder. Adapted from TheNounProject.com icons using Creative Commons Attribution License (CC BY 3.0).
See this image and copyright information in PMC

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