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.
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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.”
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