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June 11, 2014
Drug Helps Avoid Early Menopause Caused By Breast
Cancer Chemotherapy Chicago—Chemotherapy for breast cancer in young women is often lifesaving, but it also can have an extremely deleterious side effect—inducing early menopause that reduces childbearing years. Now, a new clinical trial finds that the risk of early menopause can be significantly reduced by adding an injectable gonadotropin-releasing hormone superagonist, goserelin, to the chemotherapy regimen. Study results, presented recently at the 2014 American Society of Clinical Oncology 50th Annual Meeting in Chicago, suggest that women who took goserelin and wanted to have children were more likely to have a successful pregnancy. “We found that, in addition to reducing the risk of early menopause, and all of the symptoms that go along with menopause, goserelin was very safe and may even improve survival,” said senior author Kathy Albain, MD, of Loyola University Medical Center. “I think these findings are going to change our clinical practice.” Chemotherapy-induced menopause tends to come on suddenly with more intense symptoms, the authors note. “Early menopause in younger breast cancer patients can be very debilitating,” Albain explained. For the phase III multicenter trial, which included premenopausal women younger than 50 who had estrogen and progesterone receptor negative early-stage breast cancer, 131 patients were randomly assigned to receive standard chemotherapy while another 126 were assigned to receive chemotherapy plus goserelin. During the clinical trial, women assigned to the intervention group received one shot of goserelin, marketed as Zoladex, once every 4 weeks. Within 2 years, 45% of participants receiving standard chemotherapy had stopped menstruating or had elevated levels of follicle-stimulating hormone (FSH), an indication of reduced estrogen production and egg supply. Of those receiving goserelin, however, only 20% had stopped menstruating or had elevated FSH. In fact, the overall pregnancy rate was nearly twice as high in the goserelin group—21% versus 11%. After 4 years, 89% of the patients who received goserelin showed no signs or symptoms of cancer, compared with 78% of those receiving standard chemotherapy. Overall survival at 4 years, meanwhile, was 92% in the goserelin group and 82% in the standard chemotherapy group. “Premenopausal women beginning chemotherapy for early breast cancer should consider this new option to prevent premature ovarian failure,” the authors conclude.
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