ASCO 2014 papers discussing use of goserelin to maintain fertility, treat ER+ tumors

[Lani]

Prevention of Early Menopause Study (POEMS)/SWOG S0230: randomized open-label phase III study[1]
Summary of Key Conclusions

Addition of goserelin to standard chemotherapy improves maintenance of ovarian function in premenopausal patients with estrogen receptor (ER)/progesterone receptor (PgR)–negative breast cancer
Reduced ovarian failure (22% vs 8%; P = .04) and dysfunction at 2 years (33% vs 14%; P = .03) with the addition of goserelin
More successful pregnancies with the addition of goserelin (P = .03)
Exploratory analysis suggested increased 4-year DFS and OS estimate with addition of goserelin (DFS: 78% vs 89%, P = .04; OS: 82% vs 92%, P = .05)
Goserelin well tolerated in this population
No increase in grade 3/4 adverse events
Investigators suggest goserelin may be an option to prevent chemotherapy-related ovarian failure in premenopausal women



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Joint subset analysis of IBCSG TEXT and SOFT: randomized, open-label, multicenter phase III trials[1,2]
Summary of Key Conclusions

Exemestane plus ovarian function suppression (OFS) significantly improves DFS, breast cancer–free interval (BCFI), and disease recurrence–free interval (DRFI) over tamoxifen plus OFS in premenopausal women with hormone receptor–positive early breast cancer
3.8% DFS improvement at 5 years
DFS improvements regardless of nodal status or chemotherapy use
No OS benefit after 5-year follow-up
Exemestane adverse event profile similar to that seen in postmenopausal women
Some patients have good prognosis with endocrine therapy alone
Generally older
Smaller tumors
Exemestane plus OFS may be new treatment option for premenopausal women with hormone receptor–positive breast cancer, according to investigators