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

Abstract

Background

Gonadotropin‐releasing hormone agonists for ovarian protection during cancer chemotherapy: systematic review and meta‐analysis

“…Five studies involved administration of triptorelin intramuscularly [23][24][25][26]35 , one used intranasal buserelin 27 , five used goserelin [28][29][30][31][32] , one administered diphereline 33 and one used leuprolide acetate 34 . In all included studies GnRHa administration was maintained throughout the chemotherapy treatment.…”

“…Nine studies defined as primary outcome the resumption of menses, which is a surrogate for preserved ovarian function [23][24][25][26][27]29,30,32,33 . From these studies we extracted the number of participants that had not resumed menses (i.e.…”

“…The duration of follow-up ranged from 6 months 33 to 7 years 25 . As secondary outcome, nine studies reported the number of participants that became pregnant during the follow-up [23][24][25][26][27][29][30][31]35 . All reported pregnancies resulted from spontaneous (i.e.…”

“…Demeestere (2016) 35 Giuseppe (2007) 24 Waxman (1987) 27 Subtotal (95% CI) Lambertini (2015) 25 Leonard (2017) 30 Moore (2015) 31 Munster (2012) 26 Song (2013) 34 Sverrisdottir (2009) and receptor negative (RR, 0.62; 95% CI, 0.33-1.14) tumors. When all patients were subdivided according to chemotherapy regimen into high toxicity vs low/medium toxicity 6 , the benefit of GnRHa therapy in preventing POI appeared to be of greater magnitude among women treated with low/medium toxicity chemotherapy (RR, 0.49; 95% CI, 0.29-0.84) compared with women treated with highly toxic chemotherapy (RR, 0.66; 95% CI, 0.45-0.96; Figure 4).…”

“…Five studies had unclear risk of selection bias because the authors did not provide any information about the randomization process or the allocation concealment 24,27,29,33,34 . Four studies had a high proportion (more than 25%) of participants randomized but not included in the final analysis and were therefore rated as unclear risk of attrition bias [30][31][32]35 . One study had high risk of attrition bias because the two groups differed significantly in their follow-up lengths 24 .…”