- The addition of goserelin, a gonadotropin-releasing hormone agonist, to chemotherapy reduces chemotherapy-induced ovarian failure, according to an earlier report of the Prevention of Early Menopause Study (POEMS) randomized controlled trial (RCT).
- This final report of POEMS shows that 5 years after treatment, goserelin+chemotherapy is associated with a higher pregnancy rate than chemotherapy alone, without adverse effects on survival in premenopausal women with estrogen receptor-negative/progesterone receptor-negative early breast cancer (eBCa).
Why this matters
- Goserelin is a good therapeutic option to protect fertility in premenopausal eBCa.
- RCT of 218 patients assigned to cyclophosphamide-containing chemotherapy with or without goserelin (3.6 mg subcutaneously every 4 weeks during chemotherapy).
- Funding: NIH; Breast Cancer Trials Australia and New Zealand; AstraZeneca.
- At 5 years after treatment, goserelin+chemotherapy (vs chemotherapy alone) was associated with a higher rate of ≥1 pregnancy: 5-year cumulative incidence, 23.1% (95% CI, 15.3%-31.9%) vs 12.2% (95% CI, 6.8%-19.2%), respectively, with an adjusted OR of 2.34 (P=.03).
- Goserelin+chemotherapy (vs chemotherapy alone) was associated with a nonsignificant prolongation of DFS (HR, 0.55; P=.09) and OS (HR, 0.45; P=.06).
- 5-year OS was 91.7% in the goserelin+chemotherapy group vs 83.1% in the chemotherapy-alone group.
- Small sample size precluded age-stratified results.