LHRH agonist treatment of breast cancer and gynecological malignancies: A review

Since 1982 LHRH agonists have been used as a treatment modality in patients with disseminated breast cancer and gynecologic malignancies, based on the assumption of steroid dependence of these cancers. They have been successfully used in the treatment of premenopausal women with breast cancer; response rates reported are 31-63%. Less optimistic results have been reported in postmenopausal breast cancer patients as well as in the treatment of women suffering from ovarian cancer. Response rates for treatment of postmenopausal breast- and ovarian cancer patients appear to be up to 22% and 29%, respectively. Studies using LHRH agonists to treat endometrial and cervical intra-epithelial neoplasia are still rare and, until now, no data about the efficacy of LHRH agonists in treating these malignancies have been reported. This paper reviews clinically important studies of LHRH agonists, including a rationale for the use of LHRH agonists in breast cancer and gynecological cancer treatment. In view of the changed endocrine state in postmenopausal women on the one hand and alterations in endocrine metabolism in breast cancer tissue on the other hand, it is concluded that it might be more effective to use a combination of LHRH agonists and other endocrine modalities to treat disseminated breast cancer and gynecological malignancies.