Hot Flash Treatment Strategies for Patients With Breast Cancer

Reducing hot flashes is often a critical component of breast cancer care, Charles L. Loprinzi, MD, explains.

Loprinzi, a consultant in the Division of Medical Oncology in the Department of Oncology at Mayo Clinic in Rochester, Minnesota, has been involved in approximately 30 clinical trials related to non-estrogenic management of chemotherapy-induced hot flashes in patients with breast cancer. Currently, Loprinzi is serving as the principal investigator of an ongoing phase 3 trial seeking to assess whether a lower dose of oxybutynin will yield fewer adverse events (AEs) in patients with breast cancer who either are not candidates for or are not interested in hormone replacement therapy.¹

During the 39th Annual Miami Breast Cancer Conference®, Loprinzi spoke with Oncology Nursing News® about how he typically helps patients manage chemotherapy-induced hot flashes.

“There are a number of non-estrogenic things that can be used [as a] treatment. Newer antidepressants, [like] selective serotonin reuptake inhibitors (SSRIs) or serotonin and norepinephrine reuptake inhibitors (SNRIs) have been around for some time. Decades ago, the very first placebo-controlled trial looked at venlafaxine, which markedly decreased hot flashes [by] about 60% vs about 20% with a placebo,” Loprinzi. “A lot of doctors, when they think of antidepressants, they think [of venlafaxine] first. I don't ever use that drug myself [to treat] hot flashes; citalopram works as well as venlafaxine and has less toxicities: with nausea upfront, and with [less] withdrawal symptoms than some people have with venlafaxine.”

Reference

1. Clinical trials: oxybutynin chloride in managing hot flashes. Mayo Clinic. Accessed March 7, 2022. https://mayocl.in/3ISrDFw