Skip to main content
Top
Published in: Journal of Hematology & Oncology 1/2015

Open Access 01-12-2015 | Research Article

Role of gonadotropin-releasing hormone analogues in metastatic male breast cancer: results from a pooled analysis

Authors: Luigi Di Lauro, Laura Pizzuti, Maddalena Barba, Domenico Sergi, Isabella Sperduti, Marcella Mottolese, Carla Azzurra Amoreo, Franca Belli, Patrizia Vici, Valerie Speirs, Daniele Santini, Ruggero De Maria, Marcello Maugeri-Saccà

Published in: Journal of Hematology & Oncology | Issue 1/2015

Login to get access

Abstract

Background

Male breast cancer is a rare malignancy. Despite the lack of prospectively generated data from trials in either the adjuvant or metastatic setting, patients are commonly treated with hormone therapies. Much controversy exists over the use of gonadotropin-releasing hormone analogues in metastatic male breast cancer patients. We conducted this study to provide more concrete ground on the use of gonadotropin-releasing hormone analogues in this setting.

Methods

We herein present results from a pooled analysis including 60 metastatic male breast cancer patients treated with either an aromatase inhibitor or cyproterone acetate as a monotherapy (23 patients) or combined with a gonadotropin-releasing hormone analogue (37 patients).

Results

Overall response rate was 43.5 % in patients treated with monotherapy and 51.3 % with combination therapy (p = 0.6). Survival outcomes favored combination therapy in terms of median progression-free survival (11.6 months versus 6 months; p = 0.05), 1-year progression-free survival rate (43.2 % versus 21.7 %; p = 0.05), median overall survival (29.7 months versus 22 months; p = 0.05), and 2-year survival rate (64.9 % versus 43.5 %; p = 0.05).

Conclusions

In metastatic male breast cancer patients, the combined use of gonadotropin-releasing hormone analogues and aromatase inhibitors or antiandrogens seems to be associated with greater efficacy, particularly in terms of survival outcomes, compared with monotherapy. Collectively, these results encourage considering these agents in the metastatic setting.
Literature
1.
go back to reference Giordano SH, Cohen DS, Buzdar AU, Perkins G, Hortobagyi GN. Breast carcinoma in men: a population-based study. Cancer. 2004;101:51–7.CrossRefPubMed Giordano SH, Cohen DS, Buzdar AU, Perkins G, Hortobagyi GN. Breast carcinoma in men: a population-based study. Cancer. 2004;101:51–7.CrossRefPubMed
2.
3.
go back to reference Shaaban AM, Ball GR, Brannan RA, Cserni G, Di Benedetto A, Dent J, et al. A comparative biomarker study of 514 matched cases of male and female breast cancer reveals gender-specific biological differences. Breast Cancer Res Treat. 2012;133:949–58.CrossRefPubMed Shaaban AM, Ball GR, Brannan RA, Cserni G, Di Benedetto A, Dent J, et al. A comparative biomarker study of 514 matched cases of male and female breast cancer reveals gender-specific biological differences. Breast Cancer Res Treat. 2012;133:949–58.CrossRefPubMed
4.
5.
go back to reference Eggemann H, Ignatov A, Smith BJ, Altmann U, von Minckwitz G, Röhl FW, et al. Adjuvant therapy with tamoxifen compared to aromatase inhibitors for 257 male breast cancer patients. Breast Cancer Res Treat. 2013;137:465–70.CrossRefPubMed Eggemann H, Ignatov A, Smith BJ, Altmann U, von Minckwitz G, Röhl FW, et al. Adjuvant therapy with tamoxifen compared to aromatase inhibitors for 257 male breast cancer patients. Breast Cancer Res Treat. 2013;137:465–70.CrossRefPubMed
6.
go back to reference Doyen J, Italiano A, Largillier R, Ferrero JM, Fontana X, Thyss A. Aromatase inhibition in male breast cancer patients: biological and clinical implications. Ann Oncol. 2010;21:1243–5.CrossRefPubMed Doyen J, Italiano A, Largillier R, Ferrero JM, Fontana X, Thyss A. Aromatase inhibition in male breast cancer patients: biological and clinical implications. Ann Oncol. 2010;21:1243–5.CrossRefPubMed
7.
go back to reference Zagouri F, Sergentanis TN, Koutoulidis V, Sparber C, Steger GG, Dubsky P, et al. Aromatase inhibitors with or without gonadotropin-releasing hormone analogue in metastatic male breast cancer: a case series. Br J Cancer. 2013;108:2259–63.CrossRefPubMedCentralPubMed Zagouri F, Sergentanis TN, Koutoulidis V, Sparber C, Steger GG, Dubsky P, et al. Aromatase inhibitors with or without gonadotropin-releasing hormone analogue in metastatic male breast cancer: a case series. Br J Cancer. 2013;108:2259–63.CrossRefPubMedCentralPubMed
8.
go back to reference Di Lauro L, Vici P, Del Medico P, Laudadio L, Tomao S, Giannarelli D, et al. Letrozole combined with gonadotropin-releasing hormone analog for metastatic male breast cancer. Breast Cancer Res Treat. 2013;141:119–23.CrossRefPubMed Di Lauro L, Vici P, Del Medico P, Laudadio L, Tomao S, Giannarelli D, et al. Letrozole combined with gonadotropin-releasing hormone analog for metastatic male breast cancer. Breast Cancer Res Treat. 2013;141:119–23.CrossRefPubMed
9.
go back to reference Zagouri F, Sergentanis TN, Chrysikos D, Zografos E, Rudas M, Steger G, et al. Fulvestrant and male breast cancer: a case series. Ann Oncol. 2013;24:265–6.CrossRefPubMed Zagouri F, Sergentanis TN, Chrysikos D, Zografos E, Rudas M, Steger G, et al. Fulvestrant and male breast cancer: a case series. Ann Oncol. 2013;24:265–6.CrossRefPubMed
10.
go back to reference Zagouri F, Sergentanis TN, Chrysikos D, Dimopoulos MA, Psaltopoulou T. Fulvestrant and male breast cancer: a pooled analysis. Breast Cancer Res Treat. 2015;149:269–75.CrossRefPubMed Zagouri F, Sergentanis TN, Chrysikos D, Dimopoulos MA, Psaltopoulou T. Fulvestrant and male breast cancer: a pooled analysis. Breast Cancer Res Treat. 2015;149:269–75.CrossRefPubMed
11.
go back to reference Lopez M. Cyproterone acetate in the treatment of metastatic cancer of the male breast. Cancer. 1985;55:2334–6.CrossRefPubMed Lopez M. Cyproterone acetate in the treatment of metastatic cancer of the male breast. Cancer. 1985;55:2334–6.CrossRefPubMed
12.
go back to reference Lopez M, Natali M, Di Lauro L, Vici P, Pignatti F, Carpano S. Combined treatment with buserelin and cyproterone acetate in metastatic male breast cancer. Cancer. 1993;72:502–5.CrossRefPubMed Lopez M, Natali M, Di Lauro L, Vici P, Pignatti F, Carpano S. Combined treatment with buserelin and cyproterone acetate in metastatic male breast cancer. Cancer. 1993;72:502–5.CrossRefPubMed
13.
go back to reference Di Lauro L, Vici P, Barba M, Pizzuti L, Sergi D, Rinaldi M, et al. Antiandrogen therapy in metastatic male breast cancer: results from an updated analysis in an expanded case series. Breast Cancer Res Treat. 2014;148:73–80.CrossRefPubMed Di Lauro L, Vici P, Barba M, Pizzuti L, Sergi D, Rinaldi M, et al. Antiandrogen therapy in metastatic male breast cancer: results from an updated analysis in an expanded case series. Breast Cancer Res Treat. 2014;148:73–80.CrossRefPubMed
14.
go back to reference Callari M, Cappelletti V, De Cecco L, Musella V, Miodini P, Veneroni S, et al. Gene expression analysis reveals a different transcriptomic landscape in female and male breast cancer. Breast Cancer Res Treat. 2011;127:601–10.CrossRefPubMed Callari M, Cappelletti V, De Cecco L, Musella V, Miodini P, Veneroni S, et al. Gene expression analysis reveals a different transcriptomic landscape in female and male breast cancer. Breast Cancer Res Treat. 2011;127:601–10.CrossRefPubMed
15.
go back to reference Giordano SH, Hortobagyi GN. Leuprolide acetate plus aromatase inhibition for male breast cancer. J Clin Oncol. 2006;24:e42–3.CrossRefPubMed Giordano SH, Hortobagyi GN. Leuprolide acetate plus aromatase inhibition for male breast cancer. J Clin Oncol. 2006;24:e42–3.CrossRefPubMed
16.
go back to reference Mauras N, O’Brien KO, Klein KO, Hayes V. Estrogen suppression in males: metabolic effects. J Clin Endocrinol Metab. 2000;85:2370–7.PubMed Mauras N, O’Brien KO, Klein KO, Hayes V. Estrogen suppression in males: metabolic effects. J Clin Endocrinol Metab. 2000;85:2370–7.PubMed
17.
go back to reference T’Sjoen GG, Giagulli VA, Delva H, Crabbe P, De Bacquer D, Kaufman JM. Comparative assessment in young and elderly men of the gonadotropin response to aromatase inhibition. J Clin Endocrinol Metab. 2005;90:5717–22.CrossRefPubMed T’Sjoen GG, Giagulli VA, Delva H, Crabbe P, De Bacquer D, Kaufman JM. Comparative assessment in young and elderly men of the gonadotropin response to aromatase inhibition. J Clin Endocrinol Metab. 2005;90:5717–22.CrossRefPubMed
18.
go back to reference Bighin C, Lunardi G, Del Mastro L, Marroni P, Taveggia P, Levaggi A, et al. Estrone sulphate, FSH, and testosterone levels in two male breast cancer patients treated with aromatase inhibitors. Oncologist. 2010;15:1270–2.CrossRefPubMedCentralPubMed Bighin C, Lunardi G, Del Mastro L, Marroni P, Taveggia P, Levaggi A, et al. Estrone sulphate, FSH, and testosterone levels in two male breast cancer patients treated with aromatase inhibitors. Oncologist. 2010;15:1270–2.CrossRefPubMedCentralPubMed
19.
go back to reference Leder BZ, Rohrer JL, Rubin SD, Gallo J, Longcope C. Effects of aromatase inhibition in elderly men with low or borderline-low serum testosterone levels. J Clin Endocrinol Metab. 2004;89:1174–80.CrossRefPubMed Leder BZ, Rohrer JL, Rubin SD, Gallo J, Longcope C. Effects of aromatase inhibition in elderly men with low or borderline-low serum testosterone levels. J Clin Endocrinol Metab. 2004;89:1174–80.CrossRefPubMed
20.
go back to reference Burnett-Bowie SA, Roupenian KC, Dere ME, Lee H, Leder BZ. Effects of aromatase inhibition in hypogonadal older men: a randomized, double-blind, placebo-controlled trial. Clin Endocrinol (Oxf). 2009;70:116–23.CrossRef Burnett-Bowie SA, Roupenian KC, Dere ME, Lee H, Leder BZ. Effects of aromatase inhibition in hypogonadal older men: a randomized, double-blind, placebo-controlled trial. Clin Endocrinol (Oxf). 2009;70:116–23.CrossRef
21.
go back to reference Maugeri-Saccà M, Barba M, Vici P, Pizzuti L, Sergi D, De Maria R, et al. Aromatase inhibitors for metastatic male breast cancer: molecular, endocrine, and clinical considerations. Breast Cancer Res Treat. 2014;147:227–35.CrossRefPubMed Maugeri-Saccà M, Barba M, Vici P, Pizzuti L, Sergi D, De Maria R, et al. Aromatase inhibitors for metastatic male breast cancer: molecular, endocrine, and clinical considerations. Breast Cancer Res Treat. 2014;147:227–35.CrossRefPubMed
22.
go back to reference Korde LA, Zujewski JA, Kamin L, Giordano S, Domchek S, Anderson WF, et al. Multidisciplinary meeting on male breast cancer: summary and research recommendations. J Clin Oncol. 2010;28:2114–22.CrossRefPubMedCentralPubMed Korde LA, Zujewski JA, Kamin L, Giordano S, Domchek S, Anderson WF, et al. Multidisciplinary meeting on male breast cancer: summary and research recommendations. J Clin Oncol. 2010;28:2114–22.CrossRefPubMedCentralPubMed
23.
go back to reference Labrie F, Bélanger A, Luu-The V, Labrie C, Simard J, Cusan L, et al. Gonadotropin-releasing hormone agonists in the treatment of prostate cancer. Endocr Rev. 2005;26:361–79.CrossRefPubMed Labrie F, Bélanger A, Luu-The V, Labrie C, Simard J, Cusan L, et al. Gonadotropin-releasing hormone agonists in the treatment of prostate cancer. Endocr Rev. 2005;26:361–79.CrossRefPubMed
24.
go back to reference Hayward JL, Carbone PP, Heuson JC, Kumaoka S, Segaloff A, Rubens RD. Assessment of response to therapy in advanced breast cancer. Cancer. 1977;39:1289–94.CrossRefPubMed Hayward JL, Carbone PP, Heuson JC, Kumaoka S, Segaloff A, Rubens RD. Assessment of response to therapy in advanced breast cancer. Cancer. 1977;39:1289–94.CrossRefPubMed
25.
go back to reference Miller AB, Hoogstraten B, Staquet M, Winkler A. Reporting results of cancer treatment. Cancer. 1981;47:207–14.CrossRefPubMed Miller AB, Hoogstraten B, Staquet M, Winkler A. Reporting results of cancer treatment. Cancer. 1981;47:207–14.CrossRefPubMed
Metadata
Title
Role of gonadotropin-releasing hormone analogues in metastatic male breast cancer: results from a pooled analysis
Authors
Luigi Di Lauro
Laura Pizzuti
Maddalena Barba
Domenico Sergi
Isabella Sperduti
Marcella Mottolese
Carla Azzurra Amoreo
Franca Belli
Patrizia Vici
Valerie Speirs
Daniele Santini
Ruggero De Maria
Marcello Maugeri-Saccà
Publication date
01-12-2015
Publisher
BioMed Central
Published in
Journal of Hematology & Oncology / Issue 1/2015
Electronic ISSN: 1756-8722
DOI
https://doi.org/10.1186/s13045-015-0147-z

Other articles of this Issue 1/2015

Journal of Hematology & Oncology 1/2015 Go to the issue
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine