Optimizing Care in HER2+ Breast Cancer: Integrating Fertility Preservation and Advanced Treatment Approaches - Episode 3
HER2+ Breast Cancer Management: Navigating GnRH Agonist Choice and Patient Experience
Panelists discuss how different gonadotropin-releasing hormone (GnRH) agonists like leuprolide and goserelin are equally efficacious for ovarian function suppression but differ in administration methods, needle size, and patient comfort.
Video content above is prompted by the following: GnRH Agonists for Ovarian Suppression
Key Themes:
- Comparison between GnRH agonists
- Different GnRH agonists (leuprolide, goserelin) are equally efficacious at reducing ovarian function
- Practical differences include needle size and administration method
- NCCN guidelines updated to include both monthly and 3-month formulations
- Monitoring ovarian suppression
- Importance of following hormone levels to ensure efficacy
- In SOFT/TEXT trial, approximately 17% of patients had breakthrough ovulation at one year
- Experts recommend following interval levels for at least the first 12 months
- Age-related considerations
- Different approaches suggested for younger patients (<35) vs those approaching menopause
- Younger patients may benefit from monthly dosing initially to ensure suppression
- Transitioning perimenopausal patients off injections requires careful monitoring
Notable Insights:
- Dr Vidal noted: “The younger patients, because we think they have more robust estrogen production, I think I tend to keep them more on the monthly dosing and only transition after a while.”
Dr McCann suggested: “Those are also patients that I might refer to a gynecologist for removal of their ovaries, too. So that then you know for certain that they’re postmenopausal, and it gets them away from the shot.”