Breast Cancer Rx Might Prevent Early Menopause

Goserelin might help prevent ovarian failure and allow women to become pregnant after breast cancer treatment

/ Author:  / Reviewed by: Robert Carlson, M.D Beth Bolt, RPh

(RxWiki News) It’s good news for young women who have had breast cancer treatment and still want a baby. A medication called goserelin may help prevent the ovarian failure often caused by chemotherapy.

Women treated with goserelin (brand name Zoladex) were also more likely to become pregnant after chemotherapy than women who did not receive this medication. Goserelin may also improve overall survival rates for women with breast cancer.

The research team cautioned that although the findings are promising, further research is necessary.

"[This] is the first study to provide strong evidence that fertility prospects are improved following ovarian suppression during chemotherapy," said lead study author Halle C. F. Moore, MD, a breast cancer oncologist at the Cleveland Clinic, in a press release. "Preserving ovarian function is a vital survivorship issue for young breast cancer patients. In addition to improving prospects for fertility, this intervention should help avoid a variety of unwanted effects of early menopause."

Dr. Moore and colleagues studied more than 200 women with breast cancer. They were between the ages of 18 and 49. These women were randomly assigned to receive goserelin plus chemotherapy or chemotherapy alone (the control group).

Goserelin helps protect the ovaries, which are vulnerable to the effects of chemotherapy. Chemotherapy is the treatment of cancer with multiple powerful medications that attack cancer cells.

Ovarian failure can cause early menopause and prevent pregnancy. Ovarian failure is a common side effect of chemotherapy and can also cause osteoporosis and, in some cases, heart disease.

Women who received goserelin and chemotherapy had an 8 percent ovarian failure rate two years after treatment. Women who received chemotherapy alone had a 22 percent ovarian failure rate, Dr. Moore and team found.

Women who received goserelin plus chemotherapy were also more likely to conceive. Twenty-one percent of goserelin-treated women became pregnant within five years — compared to 11 percent of the women in the control group.

"A cancer diagnosis is a life-changing event for anyone, but young women diagnosed with breast cancer often face a different array of challenges than the typical breast cancer patient who is in their 60s or 70s," Dr. Moore said. "Issues such as the long-term effects of treatment, impact on fertility, caring for young children, effect on career and relationships as well as concerns about genetic risk factors add to the heavy weight of a cancer diagnosis."

This study was published March 4 in the New England Journal of Medicine.

The National Cancer Institute, AstraZeneca, the Australia and New Zealand Breast Cancer Trials Group and the Breast Cancer Institute of Australia funded this research.

Study authors Dr. Gelber and Dr. Lombard disclosed non-financial support from AstraZeneca. Dr. Hortobagyi reported grant support and personal fees from Novartis and fees from Peregrine Pharmaceuticals, Pfizer and Amgen, among others. AstraZeneca manufactures goserelin.

Review Date: 
March 5, 2015
Last Updated:
March 9, 2015