SynthesisBreast cancer research and treatment2026
Three-monthly gonadotropin-releasing hormone agonist for ovarian function suppression in premenopausal breast cancer: a systematic review and meta-analysis.
Synthesis in Breast cancer research and treatment, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeOvarian function suppression (OFS) with gonadotropin-releasing hormone agonists (GnRHa) improves outcomes in premenopausal women with hormone receptor-positive (HR +) breast cancer (BC), most commonly using monthly administration. The potential equivalence of 3-monthly (3 M) versus monthly (1 M) schedules has been suggested but remains uncertain.
methodsWe performed a systematic review and meta-analysis of interventional studies comparing 3 M and 1 M GnRHa regimens in premenopausal women with HR + BC receiving endocrine therapy. Outcomes included ovarian escape (OE), mean estradiol (E2) levels, disease-free survival (DFS), progression-free survival (PFS), and adverse events. Subgroup analyses were performed by estradiol assay type, and a sensitivity analysis restricted to RCTs.
resultsFifteen studies comprising 4,324 patients were included, of whom 2,098 (48%) received a 3 M regimen. The pooled OE was 10% and showed no significant difference between schedules (RR 0.86; 95% CI 0.60-1.22; p = 0.39). Ultrasensitive assays yielded higher OE detection (31%) without inter-regimen differences (RR 0.90; 95% CI 0.38-2.14). Mean E2 concentrations at 12 weeks were similar (MD 1.36 pg/mL; 95% CI -3.66 to 6.38), with consistent findings in RCT-only analyses (MD -1.77 pg/mL; 95% CI -5.71 to 2.17). DFS (RR 1.02; 95% CI 0.67-1.56) and PFS (RR 0.86; 95% CI 0.72-1.04) were also comparable. No clinically relevant differences were observed in reported safety outcomes.
conclusion3 M GnRHa achieved OFS efficacy comparable to 1 M regimens, with no meaningful differences in survival or safety. The findings support 3 M GnRHa as a valid and practical alternative for OFS in appropriately selected premenopausal women with HR + BC.
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