Ovarian Function Suppression in Women With Breast Cancer: Degarelix Versus Triptorelin
Posted: Tuesday, March 12, 2019
According to a phase II trial published in the Journal of Clinical Oncology, neoadjuvant treatment with the gonadotropin-releasing hormone (GnRH) antagonist degarelix was more effective than the GnRH agonist triptorelin in achieving ovarian function suppression among premenopausal women being treated with letrozole for advanced, endocrine-responsive breast cancer. In addition, Silvia Dellapasqua, MD, of the European Institute of Oncology IRCCS, Milan, and colleagues found that ovarian function suppression was maintained more effectively among those treated with degarelix.
The authors randomly assigned 51 premenopausal women with hormone receptor–positive, HER2-negative invasive disease to receive triptorelin plus letrozole (n = 26) or degarelix plus letrozole (n = 25). The time to optimal ovarian function suppression was 3 times faster for those in the degarelix group (3 days) than for those in the triptorelin group (14 days; P < .001). Of those assigned to triptorelin, 15.4% of patients had suboptimal ovarian function suppression, whereas ovarian function suppression was maintained during subsequent cycles for all patients receiving degarelix.
Toxicity profiles were as expected, with adverse events proportionally higher with degarelix. The most common adverse events of any grade in the degarelix versus triptorelin groups were hot flashes (80% vs. 69%), arthralgia (32% vs. 54%), insomnia (24 vs. 12%), injection-site reaction (24% vs. 0%), hypertension (12% vs. 4%), and nausea (16% vs. 4%).
“These data support additional studies to assess whether degarelix improves disease control compared with the current standard of care in the treatment of premenopausal patients with breast cancer,” the authors concluded.
Disclosure: The study authors’ disclosure information may be found at ascopubs.org.