Investigator Perspectives: Nonhormonal Options for VMS in Patients with Breast Cancer

Vasomotor symptoms affect more than 50% of patients receiving endocrine therapy for hormone receptor–positive breast cancer and can reach 90% in younger patients on ovarian function suppression, with more than 20% of affected patients discontinuing treatment—a factor directly linked to increased recurrence risk and reduced survival.

Hyperactivation of hypothalamic KNDy neurons—which express kisspeptin, neurokinin B, and dynorphin—drives VMS during estrogen deprivation, providing the mechanistic basis for dual NK1/NK3 receptor antagonism as a nonhormonal strategy that may also improve sleep quality.