Estradiol levels

Kessa619

Does anyone know the optimal estradiol levels for a premenopausal woman getting lupron shots for ovarian suppression and taking an AI?

Thanks.

jojo9999

Kessa, I have the following abstract in my files of research articles related to this issue. I am not doing OS so I am not sure if lupron is the same as Triporelin - the ovarian suppression discussed in the article.

jojo

With Hormone Receptor–Positive Breast Cancer Receiving Adjuvant Triptorelin Plus Exemestane or Tamoxifen in the Suppression of Ovarian Function Trial (SOFT): The

SOFT-EST Substudy

Meritxell Bellet, Kathryn P. Gray, Prudence A. Francis, Istv´an L´ang, Eva Ciruelos, Ana Lluch,

Miguel Angel Climent, Gustavo Catal´an, Antoni Avella, Uriel Bohn, Antonio Gonz´alez-Martin, Roser Ferrer,

Roberto Catal´an, Anal´ıa Azaro, Agnita Rajasekaran, Josefa Morales, Josep V´azquez, Gini F. Fleming,

Karen N. Price, and Meredith M. Regan

See accompanying article doi:10.1200/JCO.2015.62.3728

A B S T R A C T

Purpose

To describe estradiol (E2), estrone (E1), and estrone sulfate (E1S) levels during the first year of monthly triptorelin plus exemestane or tamoxifen and to assess possible suboptimal suppression

while receiving exemestane plus triptorelin.

Patients and Methods

Premenopausal patients with early breast cancer on the Suppression of Ovarian Function Trial who

selected triptorelin as the ovarian suppression method and were randomly assigned to exemestane

plus triptorelin or tamoxifen plus triptorelin were enrolled until the target population of 120 patients

was reached. Blood sampling time points were 0, 3, 6, 12, 18, 24, 36, and 48 months. Serum

estrogens were measured with a highly sensitive and specific assay. This preplanned 12-month

analysis evaluated E2, E1, E1S, follicle-stimulating hormone, and luteinizing hormone levels in all

patients and the proportion of patients with E2 levels greater than 2.72 pg/mL at any time point

during treatment with exemestane plus triptorelin.

Results

One hundred sixteen patients (exemestane, n = 86; tamoxifen, n = 30; median age, 44 years;

median E2, 51 pg/mL; 55% prior chemotherapy) started triptorelin and had one or more samples

drawn. With exemestane plus triptorelin, median reductions from baseline E2, E1, and E1S levels

were consistently$95%, resulting in significantly lower levels than with tamoxifen plus triptorelin at

all time points. Among patients on exemestane plus triptorelin, 25%, 24%, and 17% had an E2 level

greater than 2.72 pg/mL at 3, 6, and 12 months, respectively. Baseline factors related to ontreatment

E2 level greater than 2.72 pg/mL were no prior chemotherapy (P = .06), higher body mass

index (P = .05), and lower follicle-stimulating hormone and luteinizing hormone (each P , .01).

Conclusion

During the first year, most patients on exemestane plus triptorelin had E2 levels below the defined

threshold of 2.72 pg/mL, consistent with levels reported in postmenopausal patients on aromatase

inhibitors, but at each time point, at least 17% of patients had levels greater than the threshold. J Clin Oncol 34. © 2016 by American Society of Clinical Oncology

Kessa619

thanks, jojo!

Scarlett152

I'm not sure what the optimal level is, but mine was under 5. I was 48 when I started Zoladex. Had an oophorectomy in March because I was tired in the monthly injections and was going to have a stage 2 reconstruction, so I combined the surgeries. I am still on tamoxifen due to a lot of joint pain, but the plan is to switch to an AI within the year. Good luck!

Kessa619

Thanks, Scarlett. I just turned 44. My estradiol level was 7.8. My MO acted like that was great, but I have read that lower levels are ideal. I am thinking that maybe mine were a little higher because my blood was drawn on the day I was due for my Lupron shot. That is good you were able to get the surgeries done together. I am now considering oopherectomy.

Good luck to you. Hope you are able get joint pain under control soon.