A landmark global randomised clinical trial has shown inducing temporary ‘hibernation’ of the ovaries of women with breast cancer, through a monthly injection of goserelin, a drug that disrupts the body’s hormonal feedback systems causing temporary menopause, helps prevent chemotherapy-induced menopause, and preserve fertility.
Results of the Prevention of Early Menopause Study (POEMS) of 218 women worldwide, presented overnight at the 50th annual meeting of the American Society of Clinical Oncology in Chicago, show that pre-menopausal women with breast cancer who received goserelin during chemotherapy had a 64 per cent reduction in their chance of early menopause, and were almost twice as likely to have had a baby after the end of their cancer treatment, compared to women who didn’t received the injections.
Professor Kelly-Anne Phillips, Medical Oncologist at the Peter MacCallum Cancer Centre and Study Chair of POEMS across 20 sites in Australia, Europe and New Zealand, says the results are a promising step toward helping women avoid early menopause, a potential long-term side-effect of chemotherapy.
‘In our study of young women with hormone-receptor negative breast cancer, we found eight per cent of women who received monthly injections of goserelin with their chemotherapy were in menopause two years later, compared to 22 per cent of women who had chemotherapy alone.
‘The standard approach to preserving fertility in young women with cancer is pre-chemotherapy IVF and freezing the resulting embryos or eggs until it is medically appropriate for the woman to attempt a pregnancy — through this research we have a comparatively simple and accessible way to help protect fertility in young breast cancer patients, without harming cancer outcomes.’
Professor Phillips says the research is relevant for all younger women with cancer, regardless of their reproductive intentions.
‘Early menopause brings with it the potential for increased risks of osteoporosis and other long-term health problems, so even if a pre-menopausal woman with cancer does not desire children, avoiding chemotherapy-induced menopause is still important.
Professor Phillips says younger women with other cancers that are potentially curable with chemotherapy, such as lymphoma, could also benefit from this new approach to avoiding early menopause and preserving fertility.
In Australia around 3,500 women under 50 are diagnosed with invasive breast cancer each year; nearly 800 of those are under 40.
Source: Peter Mac