Is Veozah a recommended treatment for someone with breast cancer?

Veozah is Not Recommended for Breast Cancer Treatment

Veozah (fezolinetant) is not indicated or recommended for the treatment of breast cancer patients based on current clinical guidelines. The medication is not listed in any of the breast cancer treatment guidelines reviewed 1, 2.

Understanding Breast Cancer Treatment Approach

Breast cancer treatment decisions are primarily based on:

1. Endocrine responsiveness of the tumor (ER/PR status)
2. HER2 status
3. Risk of recurrence
4. Menopausal status

Hormone Receptor-Positive Breast Cancer

For patients with hormone receptor-positive breast cancer, the recommended treatments include:

• Premenopausal patients:

  • Tamoxifen with ovarian ablation (LHRH analogue, surgery, or radiation) 1
  • Third-generation aromatase inhibitors after or with ovarian ablation 1

• Postmenopausal patients:

  • Third-generation aromatase inhibitors (anastrozole, letrozole, exemestane) 1, 2
  • Tamoxifen as an alternative 1, 2
  • Second-line options: exemestane, fulvestrant, megestrol acetate, and androgens 1

Hormone Receptor-Negative Breast Cancer

For patients with hormone receptor-negative tumors, chemotherapy is the primary systemic treatment option, with regimens including:

• Anthracyclines (doxorubicin, epirubicin)
• Taxanes (paclitaxel, docetaxel)
• Other agents (capecitabine, vinorelbine, gemcitabine) 1

HER2-Positive Breast Cancer

For HER2-positive breast cancer, trastuzumab with non-anthracycline chemotherapy is recommended 1, 2.

Why Veozah is Not Appropriate for Breast Cancer

Veozah (fezolinetant) is not mentioned in any of the breast cancer treatment guidelines reviewed. The established endocrine therapies for breast cancer include:

1. Selective estrogen receptor modulators (SERMs) like tamoxifen
2. Aromatase inhibitors (anastrozole, letrozole, exemestane)
3. Estrogen receptor antagonists (fulvestrant)
4. LHRH analogs for ovarian suppression
5. Progestins (megestrol acetate)

The treatment of breast cancer requires medications specifically studied and approved for this indication, with demonstrated effects on disease progression, mortality, and quality of life 1, 2.

Treatment Decision Algorithm

1. Determine tumor characteristics:

   • Hormone receptor status (ER/PR)
   • HER2 status
   • Stage of disease
   • Risk factors for recurrence

2. For hormone receptor-positive disease:

   • Use endocrine therapy as primary approach unless biologically aggressive disease requires faster response 1
   • Select specific agent based on menopausal status

3. For hormone receptor-negative disease:

   • Chemotherapy is the primary systemic treatment option 1

4. For HER2-positive disease:

   • Add trastuzumab to treatment regimen 1, 2

Important Considerations

• Treatment goals for metastatic breast cancer include improving quality of life and prolonging survival 1
• Response evaluation is recommended after 3 months of endocrine therapy or after 2-3 cycles of chemotherapy 1
• Concomitant chemohormonal therapy is not recommended 1, 2
• Bisphosphonates are effective for hypercalcemia and bone metastases 1

In conclusion, Veozah has no established role in breast cancer treatment based on current guidelines, and patients with breast cancer should receive evidence-based therapies specific to their tumor characteristics and disease stage.