Literature DB >> 16388519

Gonadotropin-releasing hormone analogues added to adjuvant chemotherapy protect ovarian function and improve clinical outcomes in young women with early breast carcinoma.

Francesco Recchia1, Gaetano Saggio, Giovanna Amiconi, Anna Di Blasio, Alisia Cesta, Giampiero Candeloro, Silvio Rea.   

Abstract

BACKGROUND: The objective of the current study was a retrospective evaluation of 100 consecutive premenopausal women with high-risk, early breast carcinoma who received a gonadotropin-releasing hormone (Gn-RH) analogue as ovarian protection during adjuvant chemotherapy.
METHODS: After surgery, patients received a Gn-RH analogue and adjuvant chemotherapy, which was tailored to their peculiar biologic features. The median patient age was 43 years (range, 27-50 yrs). Fifty-two women had positive estrogen receptor (ER) status, and 48 women had negative ER status. There were 64 women with Stage II breast carcinoma and 36 women with UICC Stage III breast carcinoma. All patients had their serum estradiol suppressed to values<40 pg/mL. The chemotherapy regimens administered included cyclophosphamide, methotrexate, and 5-fluorouracil (n=26 patients) and anthracycline-based regimens (n=74 patients, including 9 patients who had >10 positive axillary lymph nodes, who also received high-dose chemotherapy with autologous peripheral blood progenitor cell transplantation). Patients with positive c-erb-2 status also received a taxane. Eighty patients received radiation therapy. During therapy with the Gn-RH analogue, patients who had a positive ER status after chemotherapy received an aromatase inhibitor.
RESULTS: After a median follow-up of 75 months, normal menses were resumed by all patients younger than age 40 years and by 56% of patients older than age 40 years. Three pregnancies were observed that resulted in two normal deliveries and one voluntary abortion. The projected recurrence-free survival rates at 5 years and 10 years were 84% and 76%, respectively; and the projected overall survival rates at 5 years and 10 years were 96% and 91%, respectively.
CONCLUSIONS: The current data showed that, in premenopausal women with early breast carcinoma, the addition of a Gn-RH analogue to adjuvant therapy and temporary total estrogen suppression in patients with ER-positive disease was tolerated well, protected long-term ovarian function, and appeared to improve the expected clinical outcome. Copyright (c) 2005 American Cancer Society.

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Year:  2006        PMID: 16388519     DOI: 10.1002/cncr.21646

Source DB:  PubMed          Journal:  Cancer        ISSN: 0008-543X            Impact factor:   6.860


  27 in total

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3.  Is Chemoendocrine Treatment without Alternative?

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5.  Effect of leuprolide acetate on ovarian function after cyclophosphamide-doxorubicin-based chemotherapy in premenopausal patients with breast cancer: results from a phase II randomized trial.

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6.  Fertility preservation in women undergoing treatment for breast cancer in the UK: a questionnaire study.

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Review 7.  Female reproductive health after childhood, adolescent, and young adult cancers: guidelines for the assessment and management of female reproductive complications.

Authors:  Monika L Metzger; Lillian R Meacham; Briana Patterson; Jacqueline S Casillas; Louis S Constine; Nobuko Hijiya; Lisa B Kenney; Marcia Leonard; Barbara A Lockart; Wendy Likes; Daniel M Green
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8.  Anthracycline-based induction chemotherapy followed by concurrent cyclophosphamide, methotrexate and 5-fluorouracil and radiation therapy in surgically resected axillary node-positive breast cancer.

Authors:  Francesco Recchia; Giampiero Candeloro; Alisia Cesta; Mario DI Staso; Pierluigi Bonfili; Giovanni Luca Gravina; Ernesto DI Cesare; Stefano Necozione; Silvio Rea
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Review 9.  Ovarian preservation by GnRH agonists during chemotherapy: a meta-analysis.

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10.  GnRH agonist therapy to protect ovarian function in young Korean breast cancer patients.

Authors:  Hyun Jung Park; Young-Ah Koo; Young Hyuck Im; Byung-Koo Yoon; DooSeok Choi
Journal:  J Korean Med Sci       Date:  2009-12-26       Impact factor: 2.153

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