GnRH agonist for protection against ovarian toxicity during chemotherapy for early breast cancer: the Anglo Celtic Group OPTION trial

File Description SizeFormat 
OPTION FD.docxAccepted version149.5 kBMicrosoft WordDownload
Title: GnRH agonist for protection against ovarian toxicity during chemotherapy for early breast cancer: the Anglo Celtic Group OPTION trial
Author(s): Leonard, RCF
Adamson, DJA
Bertelli, G
Mansi, J
Yellowlees, A
Dunlop, J
Thomas, GA
Coleman, RE
Anderson, RA
Item Type: Journal Article
Abstract: Background Chemotherapy-induced premature ovarian insufficiency (POI) impacts fertility and other aspects of women’s health. The OPTION trial tested whether administration of a gonadotropin-releasing hormone agonist during chemotherapy for early breast cancer reduced the risk of POI. Patients and methods This was a prospective, randomized, parallel group study of the gonadotropin-releasing hormone agonist goserelin administered before and during chemotherapy for breast cancer with stage I–IIIB disease. The primary outcome was amenorrhoea between 12 and 24 months after randomization, supported by elevated follicle stimulating hormone concentrations to give an additional analysis as rate of POI. Results A total of 227 patients were randomized and the primary analysis was conducted on 202 patients. Goserelin reduced the prevalence of amenorrhoea between 12 and 24 months to 22% versus 38% in the control group (P = 0.015) and the prevalence of POI to 18.5% versus 34.8% in the control group (P = 0.048). Follicle stimulating hormone concentrations were also lower in all women treated with goserelin at both 12 and 24 months (P = 0.027, P = 0.001, respectively). The effect of goserelin was not statistically significant in women >40 years. Assessment of the ovarian reserve using anti-Müllerian hormone showed a marked fall in both groups during treatment to median values of 5% of pretreatment levels in the control group and 7% in the goserelin group, which were not significantly different between groups. Conclusion This study shows that goserelin reduced the risk of POI in women treated with chemotherapy for early breast cancer, with particular efficacy in women aged ≤40 years old. The degree of ovarian protection also seems limited and the clinical significance for fertility and longer term prevention of estrogen deficiency-related outcomes needs to be determined.
Publication Date: 1-Aug-2017
Date of Acceptance: 2-May-2017
URI: http://hdl.handle.net/10044/1/53621
DOI: https://dx.doi.org/10.1093/annonc/mdx184
ISSN: 0923-7534
Publisher: Oxford University Press (OUP)
Start Page: 1811
End Page: 1816
Journal / Book Title: Annals of Oncology
Volume: 28
Issue: 8
Copyright Statement: This is a pre-copyedited, author-produced PDF of an article accepted for publication in Annals of Oncology following peer review. The version of record R. C. F. Leonard, D. J. A. Adamson, G. Bertelli, J. Mansi, A. Yellowlees, J. Dunlop, G. A. Thomas, R. E. Coleman, R. A. Anderson, for the Anglo Celtic Collaborative Oncology Group and National Cancer Research Institute Trialists; GnRH agonist for protection against ovarian toxicity during chemotherapy for early breast cancer: the Anglo Celtic Group OPTION trial, Annals of Oncology, Volume 28, Issue 8, 1 August 2017, Pages 1811–1816 is available online at: https://dx.doi.org/10.1093/annonc/mdx184
Sponsor/Funder: Imperial College Trust
Funder's Grant Number: N/A
Keywords: Science & Technology
Life Sciences & Biomedicine
Oncology
breast cancer
ovary
GnRH analogue
chemoprotection
HORMONE AGONIST
RANDOMIZED-TRIAL
REMAIN PREMENOPAUSAL
WOMEN
SUPPRESSION
DAMAGE
TRIPTORELIN
MANAGEMENT
FERTILITY
GOSERELIN
GnRH analogue
breast cancer
chemoprotection
ovary
Anglo Celtic Collaborative Oncology Group and National Cancer Research Institute Trialists
Science & Technology
Life Sciences & Biomedicine
Oncology
breast cancer
ovary
GnRH analogue
chemoprotection
HORMONE AGONIST
RANDOMIZED-TRIAL
REMAIN PREMENOPAUSAL
WOMEN
SUPPRESSION
DAMAGE
TRIPTORELIN
MANAGEMENT
FERTILITY
GOSERELIN
1112 Oncology And Carcinogenesis
Oncology & Carcinogenesis
Publication Status: Published
Appears in Collections:Division of Surgery
Division of Cancer
Faculty of Medicine



Items in Spiral are protected by copyright, with all rights reserved, unless otherwise indicated.

Creative Commons