Letrozole combined with gonadotropin-releasing hormone analog for metastatic male breast cancer

• DOI: 10.1007/s10549-013-2675-y
• Publication Date: 2013-08-27T04:48:47Z
• Authors: Luigi Di Lauro; Patrizia Vici; Pietro Del Medico; Lucio Laudadio; Silverio Tomao; Diana Giannarelli; Laura Pizzuti; Domenico Sergi; Maddalena Barba; Marcello Maugeri-...
• Keywords: Antineoplastic Agents, Hormonal; Docetaxel; Kaplan-Meier Estimate; nitriles; agonists; neoplasms; hormone-dependent; ductal; radiotherapy; aromatase inhibitors; aged; adjuvant; cyclophosphamide; gonadotropin-releasing hormone analog; triazoles; endocrine therapy; metastatic disease; modified radical; drug therapy/radiotherapy/surgery; male breast cancer; fluorouracil; antineoplastic combined chemotherapy protocols; disease-free survival; therapeutic use; tamoxifen; administration /&/ dosage; male; combined modality therapy; papillary; gonadotropin-releasing hormone; letrozole; antineoplastic agents; middle aged; humans; methotrexate; progesterone; drug therapy/surgery; chemotherapy; breast neoplasms; breast; goserelin; mastectomy; hormonal; drug therapy/radiotherapy/secondary/surgery; epirubicin; kaplan-meier estimate; administration /&/ dosage/therapeutic use; estrogen receptor modulators; carcinoma; taxoids; estrogens; Disease-Free Survival; Breast Neoplasms, Male; Gonadotropin-Releasing Hormone; 03 medical and health sciences; 0302 clinical medicine; Estrogen Receptor Modulators; Antineoplastic Combined Chemotherapy Protocols; Humans; Cyclophosphamide; Aged; Epirubicin; Aromatase Inhibitors; Carcinoma, Ductal, Breast; Estrogens; Combined Modality Therapy; Carcinoma, Papillary; 3. Good health; Chemotherapy, Adjuvant; Goserelin; Fluorouracil

The role of aromatase inhibitors combined with gonadotropin-releasing hormone analog in metastatic male breast cancer patients remains unknown. In this retrospective study we evaluated the activity of letrozole combined with a gonadotropin-releasing hormone analog as a first- or second-line therapy for metastatic male breast cancer patients. 19 men entered the study. We did not observe any grade 3 or 4 adverse events. 2 patients (10.5 %) had complete response, 7 patients (36.8 %) experienced a partial response, 7 patients (36.8 %) had stable disease lasting ≥ 6 months, and 3 patients (15.8 %) had progressive disease. Overall, the disease control rate was 84.2 %. Median progression-free survival was 12.5 months (95 % CI 8.2-16.9), median overall survival was 35.8 months (95 % CI 24.4-49.2), 1- and 2-year survival rates were 89.5 and 67 %, respectively. Interestingly, 3 out of 4 patients treated with the combination following disease progression while on aromatase inhibitor monotherapy confirmed or improved the best overall response observed in the first-line setting. The combination of letrozole and gonadotropin-releasing hormone analog is effective and safe in hormone-receptor positive, metastatic male breast cancer patients.