Breast cancer: goserelin helps prevent chemotherapy-induced menopause

  • Moore HCF & al.
  • J Natl Cancer Inst
  • 27 Oct 2018

  • curated by Miriam Davis, PhD
  • Univadis Clinical Summaries
Access to the full content of this site is available only to registered healthcare professionals. Access to the full content of this site is available only to registered healthcare professionals.

Takeaway

  • 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.

Study design

  • 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.

Key results

  • 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.

Limitations

  • Small sample size precluded age-stratified results.

Please confirm your acceptance

To gain full access to GPnotebook please confirm:

By submitting here you confirm that you have accepted Terms of Use and Privacy Policy of GPnotebook.

Submit