PMID- 20832294
OWN - NLM
STAT- MEDLINE
DCOM- 20110328
LR  - 20181201
IS  - 1879-0852 (Electronic)
IS  - 0959-8049 (Linking)
VI  - 46
IP  - 16
DP  - 2010 Nov
TI  - Suppression of ovarian function in combination with an aromatase inhibitor as 
      treatment for advanced breast cancer in pre-menopausal women.
PG  - 2936-42
LID - 10.1016/j.ejca.2010.08.005 [doi]
AB  - Trials have shown superiority of aromatase inhibitors (AIs) over tamoxifen for 
      post-menopausal oestrogen receptor-positive advanced breast cancer (ER+ABC). We 
      previously reported the use of goserelin plus anastrozole (G+A) as second-line 
      endocrine therapy for pre-menopausal ER+ABC. We report clinical and endocrine 
      data from G+A as first-line systemic therapy. Thirty-six patients (median age=44 
      years) with metastatic (N=28) and locally advanced disease were administered G+A 
      for >/=6 months (unless progressed prior). Some (N=13) received further therapy 
      with goserelin plus another AI (steroidal), exemestane (G+E). Serial serum 
      hormone assays (oestradiol, dehydroepiandrosterone sulphate, testosterone, 
      follicle stimulating hormone and luteinising hormone) were performed. Twenty-four 
      patients (67%) derived clinical benefit (CB) (5% complete response, 31% partial 
      response, 31% stable disease for >/=6 months) with median time to progression and 
      duration of CB of 12 (2-47) and 24+(7-78+) months respectively. Ten patients were 
      still receiving first-line G+A at analysis. Amongst 13 patients who went onto 
      receive G+E, 38% achieved CB with a mean duration of 13+(7-32) months. Therapy 
      was well tolerated with no withdrawals. The combination of G+A resulted in 98% 
      reduction (from pre-treatment to 6-month) in median levels of oestradiol (from 
      574.5 pmol/L; inter-quartile range (IQR)=209-1426; (N=6) to 13.45 pmol/L; 
      IOQ=5.5-31.5 (N=4) whilst the levels of other hormones had minimal fluctuations 
      during therapy. The combinations of ovarian function suppression (using G) and 
      AIs produce sustained CB and minimal side effects in pre-menopausal ER+ABC with 
      significant reduction in oestradiol levels. Within the limitations of being a 
      non-randomised study, they should be considered in appropriate patients with 
      hormone-sensitive ABC.
CI  - Copyright (c) 2010 Elsevier Ltd. All rights reserved.
FAU - Cheung, K L
AU  - Cheung KL
AD  - Division of Breast Surgery, University of Nottingham, UK. 
      kl.cheung@nottingham.ac.uk
FAU - Agrawal, A
AU  - Agrawal A
FAU - Folkerd, E
AU  - Folkerd E
FAU - Dowsett, M
AU  - Dowsett M
FAU - Robertson, J F R
AU  - Robertson JF
FAU - Winterbottom, L
AU  - Winterbottom L
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20100909
PL  - England
TA  - Eur J Cancer
JT  - European journal of cancer (Oxford, England : 1990)
JID - 9005373
RN  - 0 (Androstadienes)
RN  - 0 (Aromatase Inhibitors)
RN  - 0 (Hormones)
RN  - 0 (Nitriles)
RN  - 0 (Triazoles)
RN  - 094ZI81Y45 (Tamoxifen)
RN  - 0F65R8P09N (Goserelin)
RN  - 2Z07MYW1AZ (Anastrozole)
RN  - 33515-09-2 (Gonadotropin-Releasing Hormone)
RN  - NY22HMQ4BX (exemestane)
SB  - IM
CIN - Eur J Cancer. 2010 Nov;46(16):2867-9. PMID: 20880696
MH  - Adult
MH  - Anastrozole
MH  - Androstadienes/administration & dosage
MH  - Antineoplastic Combined Chemotherapy Protocols/*therapeutic use
MH  - Aromatase Inhibitors/administration & dosage
MH  - Breast Neoplasms/*drug therapy
MH  - Female
MH  - Gonadotropin-Releasing Hormone
MH  - Goserelin/administration & dosage
MH  - Hormones/metabolism
MH  - Humans
MH  - Middle Aged
MH  - Nitriles/administration & dosage
MH  - Ovary/*drug effects
MH  - Premenopause
MH  - Tamoxifen/administration & dosage
MH  - Triazoles/administration & dosage
EDAT- 2010/09/14 06:00
MHDA- 2011/03/29 06:00
CRDT- 2010/09/14 06:00
PHST- 2010/05/26 00:00 [received]
PHST- 2010/07/28 00:00 [revised]
PHST- 2010/08/09 00:00 [accepted]
PHST- 2010/09/14 06:00 [entrez]
PHST- 2010/09/14 06:00 [pubmed]
PHST- 2011/03/29 06:00 [medline]
AID - S0959-8049(10)00786-0 [pii]
AID - 10.1016/j.ejca.2010.08.005 [doi]
PST - ppublish
SO  - Eur J Cancer. 2010 Nov;46(16):2936-42. doi: 10.1016/j.ejca.2010.08.005. Epub 2010 
      Sep 9.