Continued Benefit of Adding Goserelin to Chemotherapy in Women With Breast Cancer
Posted: Wednesday, January 16, 2019
Adding goserelin to cyclophosphamide-containing chemotherapy was associated with a higher incidence of pregnancy and a nonsignificant improvement in disease-free and overall survival for premenopausal women with stages I to IIIA estrogen receptor–negative, progesterone receptor–negative breast cancer. Halle C.F. Moore, MD, of the Cleveland Clinic Lerner College of Medicine and Taussig Cancer Institute, and colleagues published their findings from the final analysis of the POEMS/SWOG Intergroup S0230 trial in the Journal of the National Cancer Institute. The researchers previously reported a 70% reduction in ovarian failure at 2 years with the addition of goserelin to standard chemotherapy.
A total of 218 patients, between the ages of 18 and 49, were randomly assigned to be treated with chemotherapy and goserelin or chemotherapy alone. The median follow-up was 5.1 years. Of the 105 patients in the chemotherapy and goserelin arm, 23.1% reported at least 1 pregnancy, and 23.8% reported attempting pregnancy. Of the 113 patients in the chemotherapy-alone arm, pregnancy was attempted by 16.8% and reported in 12.2%. Pregnancy occurred in some women who did not report attempting to become pregnant.
Goserelin and chemotherapy treatment was associated with a nonsignificant improvement in disease-free survival, with a hazard ratio of 0.55, and overall survival, with a hazard ratio of 0.45. The 5-year disease-free survival was 88.1%, versus 78.6% without goserelin; the 5-year overall survival was 91.7%, versus 83.1% without goserelin.
“Despite challenges, consistent evidence was found that patients randomly assigned to receive goserelin were less likely to experience ovarian failure and more likely to become pregnant without adverse effect on disease-related outcomes,” the investigators concluded.
Disclosure: The study authors’ disclosure information may be found at academic.oup.com.