[Hot flushes and breast cancer with positive hormone receptors: Mechanisms and management].

Abstract

Breast cancer is the most frequently diagnosed cancer in women and the first cause of cancer death in France. Among the different subtypes of breast cancer, the predominant form is characterized by positive hormone receptors (more than 70% of breast cancers). Hormone therapy thus plays a key role in the strategy of management of these cancers both in adjuvant and metastatic situations. The two types of adjuvant hormone therapy used are selective estrogen receptor modulators and aromatase inhibitors. Fulvestrant, an anti-estrogen, is used alone or in combination with other molecules in metastatic situations. Hot flashes are one of the symptoms most frequently reported by patients under hormone therapy. Hormone replacement therapy, which is currently the most effective treatment for hot flashes, is contraindicated in patients with a personal history of breast cancer. Various therapeutic classes of drugs have been tested in this indication but without real efficacy in the various studies carried out to date, and moreover associated with non-negligible side effects. The recent discovery of the implication of the kisspeptin system located at the hypothalamic level in the mechanism of genesis of hot flashes opens the way to possible new symptomatic treatments for hot flashes. Neurokinin 3 receptor antagonists have shown encouraging preliminary results in postmenopausal cancer-free patients and could be considered in patients in hormonal therapy for breast cancer. Broader additional studies are needed to confirm these initial results.

• Authors: Iphigénie Cavadias, Roman Rouzier, Florence Lerebours, Delphine Héquet
• Journal: Bulletin du cancer (Bull Cancer) Vol. 107 Issue 11 Pg. 1171-1185 (Nov 2020) ISSN: 1769-6917 [Electronic] France
• Vernacular Title: Bouffées de chaleur et cancer du sein avec récepteurs hormonaux positifs : mécanismes et prise en charge.
• PMID: 32988609 (Publication Type: Journal Article, Review)
• Copyright: Copyright © 2020 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.

Chemical References

• Antineoplastic Agents, Hormonal
• Aromatase Inhibitors
• KISS1 protein, human
• Kisspeptins
• Receptors, Neurokinin-3
• Selective Estrogen Receptor Modulators
• Tamoxifen
• Fulvestrant

Topics

• Antineoplastic Agents, Hormonal (therapeutic use)
• Aromatase Inhibitors (therapeutic use)
• Breast Neoplasms (chemistry, drug therapy)
• Contraindications, Drug
• Estrogen Replacement Therapy (adverse effects)
• Female
• Fulvestrant (therapeutic use)
• Hot Flashes (etiology)
• Humans
• Kisspeptins (physiology)
• Ovary (drug effects, surgery)
• Receptors, Neurokinin-3 (antagonists & inhibitors)
• Selective Estrogen Receptor Modulators (administration & dosage, therapeutic use)
• Tamoxifen (administration & dosage, therapeutic use)