Depomedroxyprogesterone acetate therapy for hot flashes in survivors of breast cancer: no unfavorable impact on recurrence and survival

Natalie M. Ertz-Archambault, Lana B. Rogoff, Heidi E. Kosiorek, Brenda Ernst, Karen S. Anderson, Barbara A Pockaj, Richard J. Gray, Donald W Northfelt

Research output: Contribution to journalArticle

Abstract

Purpose: Survivors of estrogen receptor–expressing breast cancer generally do not receive estrogen-based therapy for menopausal symptoms due to concern for provoking recurrence of disease. Single-dose depomedroxyprogesterone acetate has been shown to be among the most effective non-estrogen strategies for treatment of menopausal hot flashes, but long-term evidence for safety in survivors is lacking. Methods: We conducted an institutional review board approved, retrospective, case-control cohort study at a tertiary, academic referral center. Patients with estrogen receptor-expressing early-stage operable breast cancer who received depomedroxyprogesterone acetate for hot flashes between January 2005 and December 2012 were identified. We confirmed 75 patients who met strict inclusion criteria who were matched 1:1 with controls for age, stage of disease, HER2 status, and year of diagnosis. Overall survival, loco-regional recurrence-free survival, and progression-free survival assessments for cases were compared with controls. Results: Median follow-up duration was 68.4 months in cases and 57.6 months in controls. Estimated local-regional recurrence-free survival at 10 years was 97% (95% CI, 92–100%) in cases and 98% (95% CI, 95–100%) in controls. Estimated progression-free survival at 10 years was 89% (95% CI, 80–100%) in cases and 83% (95% CI, 73–95) in controls. The majority (75%) of case patients experienced satisfactory relief of hot flashes from depomedroxyprogesterone injection. Discussion: In this retrospective case-control study, we were unable to identify a detrimental effect of depomedroxyprogesterone acetate therapy for hot flashes in survivors of estrogen receptor–expressing breast cancer. Depomedroxyprogesterone acetate may be acceptable for management of hot flashes in this population.

Original languageEnglish (US)
JournalSupportive Care in Cancer
DOIs
StateAccepted/In press - Jan 1 2019

Fingerprint

Hot Flashes
Survivors
Acetates
Breast Neoplasms
Recurrence
Survival
Estrogens
Disease-Free Survival
Case-Control Studies
Therapeutics
Research Ethics Committees
Tertiary Care Centers
Estrogen Receptors
Cohort Studies
Safety
Injections
Population

Keywords

  • Breast neoplasms
  • Hot flashes
  • Medroxyprogesterone acetate
  • Survivors

ASJC Scopus subject areas

  • Oncology

Cite this

Depomedroxyprogesterone acetate therapy for hot flashes in survivors of breast cancer : no unfavorable impact on recurrence and survival. / Ertz-Archambault, Natalie M.; Rogoff, Lana B.; Kosiorek, Heidi E.; Ernst, Brenda; Anderson, Karen S.; Pockaj, Barbara A; Gray, Richard J.; Northfelt, Donald W.

In: Supportive Care in Cancer, 01.01.2019.

Research output: Contribution to journalArticle

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abstract = "Purpose: Survivors of estrogen receptor–expressing breast cancer generally do not receive estrogen-based therapy for menopausal symptoms due to concern for provoking recurrence of disease. Single-dose depomedroxyprogesterone acetate has been shown to be among the most effective non-estrogen strategies for treatment of menopausal hot flashes, but long-term evidence for safety in survivors is lacking. Methods: We conducted an institutional review board approved, retrospective, case-control cohort study at a tertiary, academic referral center. Patients with estrogen receptor-expressing early-stage operable breast cancer who received depomedroxyprogesterone acetate for hot flashes between January 2005 and December 2012 were identified. We confirmed 75 patients who met strict inclusion criteria who were matched 1:1 with controls for age, stage of disease, HER2 status, and year of diagnosis. Overall survival, loco-regional recurrence-free survival, and progression-free survival assessments for cases were compared with controls. Results: Median follow-up duration was 68.4 months in cases and 57.6 months in controls. Estimated local-regional recurrence-free survival at 10 years was 97{\%} (95{\%} CI, 92–100{\%}) in cases and 98{\%} (95{\%} CI, 95–100{\%}) in controls. Estimated progression-free survival at 10 years was 89{\%} (95{\%} CI, 80–100{\%}) in cases and 83{\%} (95{\%} CI, 73–95) in controls. The majority (75{\%}) of case patients experienced satisfactory relief of hot flashes from depomedroxyprogesterone injection. Discussion: In this retrospective case-control study, we were unable to identify a detrimental effect of depomedroxyprogesterone acetate therapy for hot flashes in survivors of estrogen receptor–expressing breast cancer. Depomedroxyprogesterone acetate may be acceptable for management of hot flashes in this population.",
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AU - Ertz-Archambault, Natalie M.

AU - Rogoff, Lana B.

AU - Kosiorek, Heidi E.

AU - Ernst, Brenda

AU - Anderson, Karen S.

AU - Pockaj, Barbara A

AU - Gray, Richard J.

AU - Northfelt, Donald W

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AB - Purpose: Survivors of estrogen receptor–expressing breast cancer generally do not receive estrogen-based therapy for menopausal symptoms due to concern for provoking recurrence of disease. Single-dose depomedroxyprogesterone acetate has been shown to be among the most effective non-estrogen strategies for treatment of menopausal hot flashes, but long-term evidence for safety in survivors is lacking. Methods: We conducted an institutional review board approved, retrospective, case-control cohort study at a tertiary, academic referral center. Patients with estrogen receptor-expressing early-stage operable breast cancer who received depomedroxyprogesterone acetate for hot flashes between January 2005 and December 2012 were identified. We confirmed 75 patients who met strict inclusion criteria who were matched 1:1 with controls for age, stage of disease, HER2 status, and year of diagnosis. Overall survival, loco-regional recurrence-free survival, and progression-free survival assessments for cases were compared with controls. Results: Median follow-up duration was 68.4 months in cases and 57.6 months in controls. Estimated local-regional recurrence-free survival at 10 years was 97% (95% CI, 92–100%) in cases and 98% (95% CI, 95–100%) in controls. Estimated progression-free survival at 10 years was 89% (95% CI, 80–100%) in cases and 83% (95% CI, 73–95) in controls. The majority (75%) of case patients experienced satisfactory relief of hot flashes from depomedroxyprogesterone injection. Discussion: In this retrospective case-control study, we were unable to identify a detrimental effect of depomedroxyprogesterone acetate therapy for hot flashes in survivors of estrogen receptor–expressing breast cancer. Depomedroxyprogesterone acetate may be acceptable for management of hot flashes in this population.

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