Goserelin in Premenopausal Advanced Breast Cancer: Clinical and Endocrine Evaluation of Responsive Patients

Abstract

Medical ovariectomy with goserelin is an alternative to surgical oophorectomy. To evaluate the relationship between tumor regression and endocrine changes induced by therapy, 40 premenopausal patients with advanced breast cancer were given 3.6 mg of goserelin subcutaneously fortnightly for the first 4 doses and every 28 days thereafter. We have made a particular analysis of the clinical and endocrine profile of responsive patients. Objective responses were observed in 17 of the 38 evaluable patients (45%), 6 cases achieving complete remission. Serum estradiol was suppressed in castrated women, although there was a tendency towards an increase in serum follicle-stimulating hormone over time. No statistically significant difference was observed in the hormonal profiles of patients experiencing a complete or partial response. Our experience confirms that goserelin is as effective as oophorectomy and that there is a clear correspondence between clinical response and drug-induced estrogen suppression.

Canine Mammary Tumours, an Overview

“…Goserelin , a LHRH agonist, is effective in the treatment of women with hormone‐dependent breast cancer. It reduces hormone levels to almost zero (Bajetta et al. 1994).…”

Randomized Trial of Adjuvant Tamoxifen and/or Goserelin in Premenopausal Breast Cancer-Self-rated Physiological Effects and Symptoms

“…On the anxiety scale, 49% in the Z-group and 41% in the control group scored ] 8 at 12 months, compared Table 4 Number of patients (x 2 analysis) reporting symptoms (scores [1][2][3][4] 1 No statistical differences between groups were found at any of the points of assessments.…”

“…In recent years, luteinizing hormone releasing hormone (LHRH) analogues have become available in adjuvant settings. The hormonal effects in premenopausal women are the same as those with ovarian ablation (3,4) but the treatment does not entail surgery or radiation therapy and has the potential advantage of being reversible. Goserelin acts on the hypothalamic-pituitary axis, achieving ovarian suppression by receptor down-regulation, decreasing luteinizing hormone and oestradiol levels to postmenopausal values (5).…”

Ovarian function suppression with a GnRH analogue: d‐ser(But[t])[6]‐Arzgly[10]‐LHRH (Goserelin) in hormone dependent canine mammary cancer

“…Testosterone suppression by oestrogen administration can produce tumour shrinkage and regression of metastases, however, oestrogen treatment is frequently associated with a severe risk of cardiovascular complications ( Robustelli della Cuna, 1992). The advent of compounds that interact in the pituitary gland with the luteinizing hormone‐releasing hormone (LHRH)‐agonists has led to an alternative method of hormone manipulation ( Peeling, 1989; Bajetta et al ., 1994a ; Boccardo et al ., 1994 ). Some of these agonists are more potent than naturally occurring LHRH and, when continuously administered, they cause an initial stimulatory effect on gonadotropin release and a gonadal steroid output followed by a down regulation of pituitary LHRH receptors, with a consequent decrease in serum testosterone and oestradiol concentrations ( Vickery et al ., 1989 ; Mettler et al ., 1991 ; Cedars et al ., 1992 ).…”