Goserelin for Ovarian Protection during Breast-Cancer Adjuvant Chemotherapy

Women with hormone-receptor–negative breast cancer who received goserelin with adjuvant chemotherapy had less amenorrhea and better fertility at 2 years after treatment, and better rates of disease-free and overall survival, than did those who received chemotherapy alone. Early ovarian failure is an important and potentially devastating long-term toxic effect of chemotherapy. Manifestations include menopausal symptoms, osteoporosis, and infertility. Concerns about fertility may influence treatment choices for young women with breast cancer 1 , 2 despite the known survival benefit of adjuvant chemotherapy. Trials of the coadministration of a gonadotropin-releasing hormone (GnRH) agonist with adjuvant chemotherapy for the purpose of protecting ovarian function have shown mixed results. 3 A large randomized trial addressing this issue suggested that coadministration of a GnRH agonist with chemotherapy had an ovarian protective effect in a cohort of patients in which 86% had estrogen-receptor–positive breast cancer, . . .