Luteininzing hormone releasing hormones analogs in combination with tamoxifen for the adjuvant treatment of premenopausal women with hormone receptor positive breast cancer

Expert Opin Pharmacother. 2017 Sep;18(13):1357-1362. doi: 10.1080/14656566.2017.1363181. Epub 2017 Aug 10.


The role of ovarian function suppression (OFS) through luteinizing hormone-releasing hormone agonists (LHRHa) in addition to tamoxifen has been questioned until recently. In 2015, two large clinical trials led to a paradigm shift in the adjuvant endocrine treatment of premenopausal women, introducing the use of LHRHa plus tamoxifen (or aromatase inhibitor, AI) into current clinical practice. Areas covered: The present review aims to provide an in-depth overview of the role of LHRHa+tamoxifen for the adjuvant treatment of premenopausal women with hormone receptor positive breast cancer (HR+BC). Expert opinion: The addition of LHRHa to endocrine treatment (either tamoxifen or AI) is effective in premenopausal women who are at high risk of relapse. To date, no clear recommendations are available for the choice between LHRHa+tamoxifen and LHRH+AI. Although recent data showed better DFS with LHRHa+AI, other issues should be considered: 1) approximately 20 out of 100 women do not reach complete OFS with LHRHa+AI; 2) there is no extended endocrine therapy option that can be applied to women who received 5 years of LHRHa+AI and remained premenopausal at the end of the fifth year. Long-term results of the SOFT-TEXT study are needed to establish if LHRHa+AI is superior to LHRHa+tamoxifen.

Keywords: Gonadotropin-releasing hormones analogs; aromatase inhibitors; breast cancer; ovarian function suppression; premenopausal women; tamoxifen.

Publication types

  • Review

MeSH terms

  • Antineoplastic Agents, Hormonal / administration & dosage
  • Antineoplastic Agents, Hormonal / therapeutic use*
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Aromatase Inhibitors / administration & dosage
  • Aromatase Inhibitors / therapeutic use
  • Breast Neoplasms / drug therapy*
  • Chemotherapy, Adjuvant
  • Clinical Trials as Topic
  • Disease-Free Survival
  • Female
  • Gonadotropin-Releasing Hormone / administration & dosage
  • Gonadotropin-Releasing Hormone / analogs & derivatives*
  • Gonadotropin-Releasing Hormone / therapeutic use*
  • Humans
  • Neoplasm Recurrence, Local / prevention & control
  • Ovary / drug effects
  • Premenopause
  • Tamoxifen / administration & dosage
  • Tamoxifen / therapeutic use*


  • Antineoplastic Agents, Hormonal
  • Aromatase Inhibitors
  • Tamoxifen
  • Gonadotropin-Releasing Hormone