Dr. McAndrew on Chemotherapy Vs Ovarian Function Suppression in HR+ Breast Cancer

Nicholas P. McAndrew, MD, MSCE, assistant clinical professor of Medicine, University of California, Los Angeles (UCLA), hematologist-oncologist, UCLA David Geffen School of Medicine, UCLA Medical Center, discusses the relationship between chemotherapy and ovarian function suppression in hormone receptor (HR)–positive, HER2-negative breast cancer.

Premenopausal patients with HR-positive, HER2-negative breast cancer can experience a benefit from treatment with chemotherapy, McAndrew says. However, it is unclear if that benefit stems from the cytotoxic properties of the chemotherapy, or if it is associated with ovarian function suppression in an estrogen-depleted state, leading to the indirect killing of cancer cells by restricting the amount of estrogen-related growth, McAndrew adds.

Notably, benefits from chemotherapy were observed in premenopausal patients with HR-positive breast cancer who were node negative and high risk, or node positive with involvement of 1-3 nodes in the phase 3 RxPONDER trial (NCT01272037). On the trial, patients that had a recurrence score between 0 and 25 all experienced a benefit from chemotherapy. This added to the intense debate of the relationship between chemotherapy and ovarian function suppression in this patient population, McAndrew concludes.