- The Asian Breast Cancer Cooperative Group 2019 issued a new consensus and position paper on ovarian function suppression (OFS) for hormone receptor (HR)-positive/human epidermal growth factor receptor 2 (HER2)-negative breast cancer (BCa).
- The guidance is more conservative on the use of OFS than near universal use recommended by the European School of Oncology and European Society for Medical Oncology.
Why this matters
- Premenopausal Asian women have seen dramatic growth in BCa incidence and younger age at peak incidence than Western women.
- Guidance is needed because of the absence of clinical trials with Asian women.
- A 12-member committee reported consensus when there was a ≥75% majority.
- A literature review was provided.
- Funding: Novartis.
Key consensus points
- More trials of endocrine therapy in premenopausal women are needed.
- Early HR+/HER2− breast cancer:
- Not all premenopausal women need adjuvant OFS.
- Specific clinical factors should guide OFS prescribing, including subpopulation results of SOFT and TEXT clinical trials showing that patients with low progesterone receptor expression and/or high Ki-67 expression obtain greater absolute benefit from OFS.
- High-risk patients (high recurrence score) who remain premenopausal after adjuvant chemotherapy should be treated with OFS+aromatase inhibitor rather than tamoxifen, despite no clear overall survival benefit.
- No consensus was reached on preferred modality for OFS.