CHICAGO May 30 A new treatment approach may
help thousands of women with early-stage breast cancer avoid
premature menopause and preserve their ability to have children,
U.S. researchers said on Friday.
Their study, presented at the American Society of Clinical
Oncology meeting in Chicago, showed that women who received
AstraZeneca PLC's drug goserelin along with chemotherapy
were 64 percent less likely to develop premature menopause than
women who had chemotherapy alone. They were also more likely to
have successful pregnancies, and the treatment appeared to
Early menopause is a common side effect for younger women
undergoing chemotherapy for hormone-receptor-negative breast
cancer, a type of cancer not driven by the hormone estrogen or
About a quarter of breast cancers occur in women under 50,
affecting some 40,000 to 50,000 women each year. Unlike natural
menopause, which occurs gradually, chemotherapy can suddenly
throw a woman into full-blown menopause. In about half of these
women, this condition is permanent, eliminating the chance for a
"This is the first time anything has been shown to prevent
this," said Dr. Kathy Albain of Loyola University Medical
Center, a senior author of the study. "I think these findings
are going to change our clinical practice."
Goserelin, whose brand name is Zoladex, closely resembles a
hormone normally released by the hypothalamus. It is already
approved for prostate and advanced breast cancers. In
premenopausal women, the drug temporarily shuts down the
ovaries, essentially putting them on hold during chemotherapy.
Out of 257 patients in the trial, half received chemotherapy
alone and half got chemotherapy plus monthly injections of
After two years, 8 percent of women in the goserelin group
had organ failure versus 22 percent in the standard chemotherapy
arm. Among those getting goserelin, 22 women (21 percent) got
pregnant compared with 12 women (11 percent) receiving
chemotherapy alone. Of these, 16 women in the goserelin group
delivered at least one healthy baby versus eight in the control
group. Another three patients from the goserelin group and two
from the control group were still pregnant when the data was
During the study's design, researchers were concerned that
adding the hormone treatment might hurt the women's breast
But the results suggest women who got goserelin were 50
percent more likely to be alive four years after starting
treatment compared with those receiving the standard therapy.
Goserelin is not currently approved for preventing ovarian
failure in women with early-stage breast cancer. While doctors
can prescribe it "off-label," Albain said it is not clear
whether insurance companies would cover it.
"We have to hope that will get settled relatively quickly,"
Dr. Claudine Isaacs of Georgetown Lombardi Comprehensive
Cancer Center, who was not involved in the study, noted that
younger women often survive breast cancer. "Anything we can do
to allow these women to live a normal life is the goal."
(Reporting by Julie Steenhuysen; Editing by Michele Gershberg
and Jonathan Oatis)