A recent study published in The New England Journal of Medicine found that early menopause can be prevented and fertility might be preserved in young women suffering from early stage breast cancer.
The outcomes of an international clinical trial highlight the fact that the risks associated with sudden onset of menopause can be significantly diminished by adding a specific drug, goserelin, to the regimen used in chemotherapy.
The study found that women who took goserelin were more likely to become pregnant and deliver a healthy baby.
“Some of the most distressing side effects of chemotherapy in young women with breast cancer are early and sudden onset of menopause and infertility. These findings provide hope for young women with breast cancer who would like to prevent early menopause or still have children,” said study senior author, Kathy Albain, from the Loyola University Chicago Cardinal Bernardin Cancer Center’s Breast Cancer Clinical Research Program in a press release.
Goserelin has the capacity to put the ovaries “at rest” temporarily during chemotherapy treatment. “We found that, in addition to reducing the risk of sudden, early menopause, and all of the symptoms that go along with menopause, goserelin was very safe and may even improve survival. These findings are changing how we manage young women with breast cancer,” explained Dr. Albain.
Premenopausal women who had certain types of early-stage breast cancer (estrogen and progesterone-receptor negative) and who were less than 50 years old were included in the phase 3 multi center trial. A total of 257 patients were selected to receive either standard chemotherapy treatments or chemotherapy plus goserelin.
After 2 years, 22 percent of women receiving standard treatment stopped menstruating and had high levels of FSH, a hormone that evidences reduced estrogen production. Only 8 percent of women receiving goserelin evidenced elevated FSH or stopped menstruating. The pregnancy rates were 21 versus 11 percent, respectively.
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After 4 years, 78 percent of women treated with standard chemotherapy evidenced no symptoms or signs of cancer in comparison to 89 percent of those on goserelin. The overall survival at 4 years corresponded to 82 and 92 percent respectively.
“Premenopausal women beginning chemotherapy for early breast cancer should consider this new option to prevent premature ovarian failure,” the team concluded.
The clinical trial, under the name “Prevention of Early Menopause Study (POEMS) S0230″ intends to protect fertility of breast cancer patients. Goserelin (Zoladex) is similar to a natural hormone produced by the body and has been FDA-approved to address prostate cancer, some benign gynecological disorders and several breast cancers.
After undergoing chemotherapy, several women under the age of 50 enter menopause. “Early menopause in younger breast cancer patients can be very debilitating,” stated Dr. Albain.