Use of LHRH-agonists as adjuvant therapy for breast cancer.
Individual data was collected for 11,906 women in 16 randomised trials evaluating a luteinising-hormone-releasing hormone (LHRH) agonist either alone, as an addition to tamoxifen or chemotherapy or in place of chemotherapy. When used alone these agents led to a large (28%) relative decrease in recurrence, which was not significant (p = 0.08) due to the small number of patients randomised. Addition of LHRH-agonist to tamoxifen, chemotherapy or both, reduced recurrence by 13% (p = 0.02), and when used alone these agents showed similar efficacy to chemotherapy. The largest effect after chemotherapy was seen in women aged <or= 40 years. Most of the chemotherapy was CMF-based, so comparisons with more modern chemotherapy would be useful. In addition, the optimum duration of treatment is unknown.
Cuzick
Jack
J
University of London, Cancer Research UK Centre for Epidemiology, Mathematics and Statistics, Wolfson Institute of Preventive Medicine, Queen Mary, Charterhouse Square, London, EC1M 6BQ, UK. jack.cuzick@cancer.org.uk