hormone therapy

Overview

Hormone therapy is a broad class of medical treatment that alters endocrine signaling to slow, suppress, or modulate disease processes. In oncology, it is most commonly used to treat hormone-sensitive Cancers by reducing the activity of endogenous hormones or by blocking their receptors. This includes endocrine therapy for breast cancer, such as tamoxifen and aromatase inhibitors like letrozole, anastrozole, and exemestane, as well as androgen deprivation approaches used in prostate cancer. Because many tumors depend on hormonal signaling for growth and survival, hormone therapy can be an important component of adjuvant, neoadjuvant, or metastatic treatment strategies.

Its biological significance lies in the fact that hormone-driven pathways can influence tumor proliferation, recurrence risk, metastatic escape, and treatment response heterogeneity. Recent research contexts also show that hormone therapy is often studied in combination with other modalities, including Cyclin-dependent kinase 4/6 inhibitors, radiotherapy, and immunotherapy-related approaches, reflecting its central role in multimodal cancer care.

Recent Publications Summary

Recent publications on hormone therapy have focused largely on breast cancer adherence, treatment uptake, and its role within combined regimens. In women with breast cancer, a cross-sectional study applying temporal self-regulation theory found that about one in seven had low endocrine therapy adherence, and that connectedness beliefs-barriers, intention, self-regulatory capacity, and behavioral prepotency were directly associated with adherence; self-regulatory capacity and behavioral prepotency also partially mediated the intention–adherence relationship 42443659Jul. In ductal carcinoma in situ, a surgeon-led program was evaluated for its impact on endocrine therapy uptake, reflecting ongoing efforts to improve use of this treatment after surgery 41572119Jan.

Several studies examined hormone therapy in the context of treatment delivery and completion in older patients with early-stage hormone receptor-positive breast cancer. One cohort study of women aged 65 years and older assessed factors associated with not starting or discontinuing hormone therapy among patients who would have been eligible for radiation omission, emphasizing that completion of 5 years of hormone therapy is often assumed when considering de-escalation of radiation but is not always achieved in practice 41690555Feb. Another analysis of practice patterns in women aged 65 and older highlighted uncertainty in the optimal balance between endocrine therapy and radiation therapy, given challenges in delivering both treatments 42159636May.

Hormone therapy was also studied alongside other systemic or local therapies. A rapid communication on early breast cancer described perceptions and initial experiences with abemaciclib plus endocrine therapy as adjuvant targeted therapy, noting that early-onset diarrhea is common and may affect adherence 42169666May. In older patients with HR+/HER2- advanced breast cancer, a PALMARES-2 sub-analysis evaluated real-world effectiveness of CDK4/6 inhibitors added to endocrine therapy, reflecting the standard first-line use of this combination regardless of age 42048902Apr.

Beyond breast cancer, hormone therapy was investigated in prostate cancer and in relation to broader treatment resistance mechanisms. A mechanistic and translational study reported that targeting FOSL2 altered PD-L1 expression and modulated hormone therapy response heterogeneity; in vivo, FOSL2 targeting enhanced antitumor effects when combined with hormone therapy and anti-PD-L1 treatment 41615411Jan. Another commentary on selective translation in cancer described how inhibition of eIF4E cap binding rewired the prostate cancer translatome and promoted renewed sensitivity to hormone therapy, underscoring translational control as a potential route to overcome resistance 42294890Jun. A nationwide register-based matched cohort study also examined endocrine therapy and COVID-19 outcomes in women with breast cancer, reflecting concern about the safety of ongoing hormone therapy during the pandemic 42121073May.

What Changes, What Holds

1. Adherence is a major limiting factor for endocrine therapy benefit -- NEW DIRECTION -- Recent work shifts attention from drug choice to real-world use: a meaningful minority of patients do not take endocrine therapy as intended, and beliefs, intention, and self-regulatory capacity appear to shape adherence 42443659Jul. The surgeon-led uptake program in ductal carcinoma in situ points in the same direction, suggesting that improving outcomes may depend as much on implementation and patient behavior as on the endocrine strategy itself 41572119Jan.

2. Radiation de-escalation depends on endocrine therapy completion, which is not assured -- NEW DIRECTION -- Older women eligible for radiation omission may not actually complete the 5-year hormone therapy course that underpins that de-escalation logic 41690555Feb. That does not overturn the established role of hormone therapy in early hormone receptor-positive breast cancer, but it does expose a practical gap between trial-based assumptions and routine care. The balance between endocrine therapy and radiation therefore remains unsettled in older patients 42159636May.

3. Adding CDK4/6 inhibition makes endocrine therapy more effective but harder to tolerate -- REINFORCES -- abemaciclib plus endocrine therapy fits the baseline view that hormone therapy is central to multimodal cancer care, especially in breast cancer, and the new data mainly sharpen the implementation problem: early diarrhea may threaten adherence 42169666May. The older-patient PALMARES-2 analysis likewise supports the established first-line combination of CDK4/6 inhibition with endocrine therapy across age groups rather than changing the underlying role of hormone therapy 42048902Apr.

4. Resistance biology now extends to translational control and immune signaling -- NEW DIRECTION -- Mechanistic work broadens the baseline account by showing that hormone therapy response heterogeneity can be modified through FOSL2-linked PD-L1 regulation and through eIF4E cap-binding control in prostate cancer 41615411Jan42294890Jun. That leaves the established use of hormone therapy intact, but it adds a more specific resistance framework: endocrine sensitivity may be recoverable by targeting translation or immune-evasion pathways, a role not covered in the overview.

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Overview update candidates: ** adherence and uptake barriers; incomplete completion of planned endocrine therapy in older patients; resistance mechanisms involving FOSL2/PD-L1 and translational control.