Clinical and endocrine data for goserelin plus anastrozole as second-line endocrine therapy for premenopausal advanced breast cancer

Goserelin plus letrozole as first- or second-line hormonal treatment in premenopausal patients with advanced breast cancer

“…The ORR of 12.5% (2/16) and the CB ratio of 56.3% (9/16) in women treated with goserelin and letrozole as the second-line endocrine treatment is slightly lower than that reported by Forward [5]. The difference may be due to the fact that Forward included only patients who previously responded to goserelin and tamoxifen without palliative chemotherapy.…”

“…Because aromatase inhibitors have proven better than tamoxifen in postmenopausal women with ER-positive breast cancer [15][16][17], the combination of an aromatase inhibitor with ovarian suppression has been studied in clinical trials as an alternative to tamoxifen in premenopausal patients. Combination therapy involving an LH-RH agonist plus anastrozole appeared to be safe and beneficial in premenopausal women with metastatic breast cancer in a study of a relatively small number of patients and short overall follow-up [5]. Though results from direct head-to-head comparisons between letrozole and anastrozole are lacking, some studies confirmed that letrozole is a more potent suppressor than anastrozole of both plasma and tissue estrogen levels in postmenopausal women with breast cancer [18,19].…”

“…The Austrian Breast and Colorectal Cancer Study Group (ABCSG-12) reported results showing that goserelin plus anastrozole yielded clinical outcomes that were similar to those of goserelin plus tamoxifen in premenopausal women with hormone-responsive early breast cancer [4]. However, very little data about goserelin with anastrozole in advanced breast cancer are currently available [5][6][7]. To the best of our knowledge, no cohort studies on the efficacy of goserelin plus letrozole in advanced breast cancer patients who had progressed on more than one cytotoxic or hormonal treatment have been reported.…”

Antitumour and biological effects of letrozole and GnRH analogue as primary therapy in premenopausal women with ER and PgR positive locally advanced operable breast cancer

“…The combination of aromatase inhibitors with GnRH analogue can obtain a complete oestrogen blockade by suppression of ovarian function and of peripheral oestrogen synthesis (Smith and Dowsett, 2003). However, limited experience has been described with aromatase inhibitors in combination with ovarian function suppression in premenopausal women with advanced breast cancer (Forward et al, 2004). Aromatase inhibitors in combination with GnRH analogues have not been systematically studied as preoperative therapy in premenopausal women with locally advanced operable breast cancer.…”

Oestrogen-selective modulation of FSH and LH secretion by pituitary gland

“…We read the interesting article by Forward et al (2004) on the clinical and endocrine data for goserelin plus anastrozole in premenopausal women with advanced breast cancer. The authors presented interesting data regarding serum gonadotropin (FSH and LH) levels and androgen (testosterone, DHEAS and androstenedione) levels in 13 patients treated with the GnRH agonist, goserelin, plus the selective oestrogen receptor modulator, tamoxifen, followed by goserelin plus the aromatase inhibitor, anastrozole.…”