Results from trials demonstrating the superiority of the third-generation aromatase inhibitors (AIs; anastrozole, letrozole and exemestane) vs. tamoxifen have led to changes in clinical practice in the treatment of postmenopausal patients with hormone-sensitive breast cancer. AIs do not inhibit ovarian oestrogen synthesis sufficiently to be a viable monotherapy for premenopausal patients but there is interest in their potential use in combination with luteinising hormone-releasing hormone analogues (LHRHas) such as goserelin (‘Zoladex’). Preliminary results from Phase II combination trials in the advanced breast cancer setting have been promising, but efficacy data in premenopausal patients with early disease are yet to be reported. Here we overview the rationale and preliminary results to date for the combination of AIs with an LHRHa and highlight ongoing trials that will more fully assess the value of such combinations in extending the treatment options for premenopausal breast cancer patients.
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