They demonstrated that gonadotropin-releasing hormone administered during adjuvant chemotherapy.
Gonadotropin-releasing hormone administered during adjuvant chemotherapy had a protective effect on ovarian function. Photo: Shutterstock.
Researchers revealed that in an effort to preserve fertility in women with breast cancer without compromising the benefits of chemotherapy in cancer control and reducing the risk of disease recurrence, have employed many strategies, including the use of analogs of gonadotropin-releasing hormoneto make the ovaries inactive during adjuvant chemotherapy.
On this, Dr. Zong reported the effects of analogs of gonadotropin-releasing hormone on ovarian function against chemotherapy-induced gonadotoxic effects in women premenopausal women with breast cancer in China.
The study was a clinical trial randomized trial to determine whether administration of gonadotropin-releasing hormone during chemotherapy in women premenopausal women with breast cancer can reduce ovarian deterioration; took place in Shanghai, China.
The investigators reported that it was an open-label trial involving premenopausal women aged 18 to 49 years with operable stages I to III, breast cancer for which treatment with adjuvant or neoadjuvant chemotherapy containing cyclophosphamide was planned in two parallel groups: treatment with chemotherapy with or without gonadotropin-releasing hormone. A total of 405 patients were enrolled in the study, but 330 were included in the primary analysis.
Eligible patients were randomly assigned (1:1) to receive chemotherapy with (n = 165) or without (n = 165) gonadotropin-releasing hormone. Those randomized to gonadotropin-releasing hormone had 3.6 mg goserelin or 3.75 mg leuprorelin injected subcutaneously once every 28 days from one to two weeks before the first cycle of chemotherapy up to four weeks after last cycle.
The primary objective was the rate of premature ovarian failure at 12 months after chemotherapy. In this study, premature ovarian failure was defined as anti-Müllerian hormone levels less than 0.5 ng/mL. Secondary endpoints were overall survival and tumor-free survival.
At 12 months after completion of chemotherapy, the rate of premature ovarian failure was 10.3% (15 of 146) in the gonadotropin-releasing hormone group and 44.5% (69 of 155) in the control group (odds ratio [OR]: 0,23; IC 95%: 0,14 a 0,39; p < 0,001). La reanudación de la hormona antimülleriana en el grupo de hormona liberadora de gonadotropina fue significativamente mejor que en el grupo de control (15 de 25 frente a 6 de 44; OR: 4,40; IC 95%: 1,96 a 9,89; p < 0,001).
After a median follow-up of 49 months (range: 25 to 60 months), the differences in overall survival and four-year tumor-free survival between the two groups were not significant. A post hoc analysis showed that in patients younger than 35 years, tumor-free survival was higher in the gonadotropin-releasing hormone group than in the control group (93% vs. 62%; p = 0.004; hazard ratio [HR]: 0,15; IC 95%: 0,03 a 0,82; p = 0,03).
This randomized clinical trial found that the administration of gonadotropin-releasing hormone in chemotherapy treatment for patients premenopausal women with breast cancer reduces the risk of premature ovarian failure, which promotes recovery of ovarian function. Two earlier studies, POEMS and PROMIS-GIM6, showed that gonadotropin-releasing hormone administered during adjuvant chemotherapy had a protective effect on ovarian function and reduced the risk of chemotherapy-induced early menopause.
consulted source here.
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