Kathryn Ruddy, MD, consultant, Division of Medical Oncology, Department of Oncology, the Mayo Clinic, discusses the use of GnRH agonists in breast cancer.

Along with their use to protect ovarian function in premenopausal patients with breast cancer, GnRH agonists have also been utilized for the treatment of breast cancer, Ruddy explains. GnRH agonists have demonstrated the ability to reduce the amount of circulating estrogen in the body, Ruddy adds.

Data from the phase 3 SOFT trial (NCT00066690) and other studies have shown that premenopausal patients with hormone-responsive breast cancer who received a GnRH agonist after surgery for breast cancer were less likely to experience a recurrence than those who did not receive a GnRH agonist, Ruddy continues. Based on these data, GnRH agonists are considered for use in patients with higher-risk breast cancer that is hormonally sensitive, Ruddy says.

Adverse effects associated with the use of GnRH agonists include hot flashes, vaginal dryness, and bone thinning, Ruddy concludes.

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Kathryn Ruddy, MD, discusses the use of GnRH agonists in breast cancer.


Dr. Ruddy on the Use of GnRH Agonists in Breast Cancer

Kathryn Ruddy, MD, associate professor of Oncology, Mayo Clinic, discusses the management of central nervous system (CNS) metastases in HER2-positive breast cancer.

CNS metastases are relatively common in women with HER2-positive breast cancer. says Ruddy. There are drugs that can penetrate the blood-brain barrier into the CNS such as the combination of capecitabine and lapatinib (Tykerb), explains Ruddy.

In general, HER2-positive breast cancer tends to be treated with the combination of an anti-estrogen or chemotherapy agent with at least one HER2-directed treatment. These combinations are also a fitting approach for patients with CNS disease, adds Ruddy. Moreover, radiation therapy is another modality that is used to control CNS disease. The ongoing phase II RTOG1119 clinical trial is investigating the use of lapatinib and whole brain radiotherapy as a means of controlling brain metastases in HER2-positive disease. Investigators are using stereotactic radiosurgery, which is a type of radiation that is delivered directly to the tumor at a single, high dose.

Dr. Ruddy on the Management of CNS Metastases in HER2+ Breast Cancer

Kathryn Ruddy, MD, associate professor of Oncology, Mayo Clinic, discusses how genetic testing could impact treatment of patients with breast cancer.

According to Ruddy, it’s important to perform genetic testing for genes like 

, which have already been determined to play a role in care of women with strong family history of breast cancer or patients diagnosed at a younger age.

Because rates of these mutations are higher in younger women diagnosed with breast cancer, it is best to do genetic testing early as it can impact surgical treatment decisions. It can also be useful in metastatic disease where PARP inhibitors are more effective in patients with 

 mutations. Ruddy says that even though a patient here may not undergo breast surgery, understanding the mutations can still play a role in selecting systemic therapies.

Kathryn Ruddy, MD, discusses how genetic testing could impact treatment of patients with breast cancer.

Kathryn Ruddy, MD

Articles

Dr. Ruddy on the Use of GnRH Agonists in Breast Cancer

Dr. Ruddy on the Management of CNS Metastases in HER2+ Breast Cancer

Dr. Ruddy on the Importance of Genetic Testing in Breast Cancer