Practical considerations and emerging approaches for the management of vasomotor and sexual symptoms in breast cancer patients on endocrine therapies.

The review discusses the need for effective management of vasomotor symptoms and libido in breast cancer patients, emphasizing the potential role of novel agents like bremelanotide, but lacks specific data to support their use.

Summary and findings

This review discusses the management of vasomotor symptoms (VMS) and decreased libido in breast cancer patients undergoing endocrine therapy. It highlights the limitations of current pharmacologic therapies and introduces novel agents such as bremelanotide. No specific numeric findings or outcomes were reported in the abstract.

Abstract

<h4>Introduction</h4>Vasomotor symptoms (VMS) and decreased libido are common menopausal symptoms. Patients with breast cancer receiving endocrine therapy experience new or worsening menopausal symptoms. Pharmacologic therapy for VMS has been centered on selective serotonin reuptake inhibitors and serotonin norepinephrine reuptake inhibitors, gabapentin, and clonidine. These therapeutic options fall short in obtaining adequate symptom relief, illustrating a therapeutic gap in efficacious treatment modalities. There are no historical systemic treatment options for low libido.<h4>Areas covered</h4>This review summarizes the current pharmacologic therapy for VMS, focusing on the practical considerations for use of the novel VMS (fezolinetant, elinzanetant) and libido agents (flibanserin, bremelanotide). Literature search was completed with PUBMED, Cochrane Library, and Web of Science. Fezolinetant is a novel neurokinin 3 receptor antagonist that has demonstrated clinical benefit in patients without a history of breast cancer. For libido management, flibanserin and bremelanotide act as serotonin/dopaminergic modulators and melanocortin receptor agonists, respectively.<h4>Expert opinion</h4>These novel agents are eagerly awaited therapeutic options; however, clinical trials excluded breast cancer patients. This review provides clinicians with relevant considerations to assess when recommending these therapies for patients with breast cancer, while awaiting ongoing research to give additional insights for best tailoring therapy for this patient population.

Key findings

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Limitations

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Elsewhere in the PT-141 (Bremelanotide) corpus