title: LH-RH analogues in the treatment of young women with early breast cancer: long-term follow-up of a phase II study.
abstract: To prevent premature ovarian failure (POF), high-risk, premenopausal women with early breast cancer were given a luteinizing-hormone releasing hormone (LH-RH) analogue during adjuvant chemotherapy. After an adriamycin-based regimen, patients received radiation therapy concomitant with cyclophosphamide, methotrexate and 5-fluorouracil. An aromatase inhibitor was given to patients positive for the estrogen receptor (ER+). The median age was 43 years (range, 26-45). Among 200 consecutive patients, 46% had no axillary node, and 54% had a mean of 5.4 positive nodes (range, 1-25); 56% were ER+, 44% were estrogen receptor negative (ER-), 13% were triple negative, and 20 had tumors positive for the oncogene, c-erb-B2 (identified with fluorescent in situ hybridization). After a median follow-up of 105 months (range, 65-180), no patient under 40 years old exhibited POF, while 44% of patients over 40 years old exhibited POF. Eight pregnancies were recorded: 7 at term and 1 voluntary interruption. The 10-year disease-free survival and overall survival rates were 85 and 91%, respectively. These data showed that, in premenopausal patients with early breast cancer, the addition of an LH-RH analogue to adjuvant chemotherapy was well tolerated, prevented POF, and was associated with excellent disease-free survival and overall survival rates.
authors.affiliation: Oncology Unit, Civilian Hospital, Avezzano, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Recchia
authors.affiliation: Clinical Epidemilogy, University of L'Aquila, L'Aquila, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Necozione
authors.affiliation: Carlo Ferri Foundation, Monterotondo, Roma, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Bratta
authors.affiliation: Oncology Unit Civilian Hospital, Frascati, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Rosselli
authors.affiliation: Carlo Ferri Foundation, Monterotondo, Roma, Italy.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Guerriero
authors.affiliation: Carlo Ferri Foundation, Monterotondo, Roma, Italy.
authors.forename: Silvio
authors.initials: S
authors.lastname: Rea
mesh_terms: D000328:Adult; D017668:Age of Onset; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000453:epidemiology / Q000473:pathology; D018270:Carcinoma, Ductal, Breast / Q000188:drug therapy* / Q000453:epidemiology / Q000473:pathology; D018572:Disease-Free Survival; D005260:Female; D005298:Fertility / Q000502:physiology; D005500:Follow-Up Studies; D007987:Gonadotropin-Releasing Hormone / Q000031:analogs & derivatives*; D017273:Goserelin / Q000627:therapeutic use*; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D011247:Pregnancy; D018873:Pregnancy Rate; D017697:Premenopause / Q000187:drug effects*
chemical_list: D017273:Goserelin; D007987:Gonadotropin-Releasing Hormone