Luteinizing hormone-releasing hormone analogues in early breast cancer: updated status of ongoing clinical trials.

In the year 2000, the ongoing meta-analysis of the Early Breast Cancer Trialists' Collaborative Group will be updated to include additional data from over 4000 patients treated with luteinizing hormone-releasing hormone analogues, principally goserelin. Four major international trials are currently in progress to evaluate the safety and efficacy of goserelin in comparison with the current standard treatments in early breast cancer, which are chemotherapy or tamoxifen. This paper provides an outline of the protocols and main objectives of the Zoladex Early Breast Cancer Research Association (ZEBRA) trial (goserelin versus cyclophosphamide-methotrexate-5-fluorouracil [CMF]), the Cancer Research Campaign (CRC) trial (goserelin versus tamoxifen versus the combination of goserelin and tamoxifen versus no further treatment), the International Breast Cancer Study Group (IBCSG) VIII trial (goserelin versus CMF versus CMF followed by goserelin) and the Eastern Cooperative Oncology Group (ECOG)/South Western Oncology Group (SWOG) trial (cyclophosphamide-doxorubicin-5-fluorouracil [CAF] versus CAF followed by goserelin versus CAF followed by goserelin plus tamoxifen). Preliminary results are expected from the CRC trial in 1998 and from the ZEBRA and ECOG/SWOG trials in 1999. Results from the wide range of comparator regimens, treatment durations and patient subgroups investigated in these trials will greatly increase the clinical database and should help to define the optimum role for goserelin in the treatment of early breast cancer in premenopausal women.