For young women who undergo chemotherapy for breast cancer, early menopause and infertility are two serious threats.
Now researchers at the Loyola University Medical Center in Chicago have discovered that adding a goserelin drug to the chemotherapy regimen reduces the risk of early menopause and increases overall survival.
The research team led by Dr. Kathy Albain (Kathy Albain) recently presented the results of her work at the 50th annual meeting of the American Society for Clinical Oncology (ASCO), which was held in the city of Chicago.
According to the American Cancer Society, 232 670 new cases of invasive breast cancer are predicted in the US this year. Although the risk of developing breast cancer rises with age, it still affects 1 in 8 women younger than 45 years.
The main treatment for breast cancer is chemotherapy. Young women who undergo such treatment are characterized by changes in the menstrual cycle and amenorrhea (absence of menstruation), leading to premature menopause and loss of fertility.
Results "may change clinical practice" The Loyola University team conducted a Phase III clinical trial to test the effect of goserelin (the Zoladex trademark), a hormone drug that has already been approved by the FDA for the treatment of prostate cancer and certain types of breast cancer. Scientists have tried to check whether it is possible to delay the onset of menopause with goserelin in patients receiving chemotherapy.
The researchers included 257 patients under the age of 50 with early-stage breast cancer. Participants were randomly assigned to two groups. The first group (131 women) received standard chemotherapy. The second group (126 women) in addition to chemotherapy received goserelin. All patients were followed for 4 years.
Women from the second group received injections of goserelin once every 4 weeks along with the usual chemotherapy regimen, without any significant changes or additions.
Two years after the beginning of the study, the team found that 45% of the participants in the first group had stopped menstruating or had a high level of follicle-stimulating hormone (FSH) - a sign of decreased function of the ovaries. In the second group receiving goserelin, there were only 20% of such women.
Moreover, the researchers calculated that 21% of women who were treated with goserelin could, during these 4 years, become pregnant. And this is compared with 11% in the control group on standard chemotherapy.
Four years after the start of therapy, a team of researchers found that 89% of women in the goserelin group had no signs of cancer compared to 78% of the participants in the group on standard chemotherapy. At the same time, the 4-year survival was 92% and 82%, respectively, that is, goserelin also slightly increased survival.
Researchers say that goserelin works by temporarily translating the ovaries into a state of "rest". Side effects of goserelin are unlikely. They, according to scientists, were associated mainly with low activity of the ovaries, and not with the toxic effect of the drug itself.
Commenting on the results of her research, Dr. Albein wrote:
"We found that goserelin not only reduces the risk of early menopause and related problems, but it is very safe, and even improves survival. I think that these results will change our clinical practice ".
Recently, Western publications have reported an important discovery made by researchers from the Comprehensive Cancer Center at the University of Michigan. The statistical analysis carried out by them showed that the removal of both mammary glands (bilateral mastectomy) in breast cancer in most cases is not a necessary procedure.
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