RATIONALE: Goserelin may help prevent early menopause in patients undergoing chemotherapy for breast cancer. It is not yet known whether goserelin is effective in preventing early menopause in women undergoing chemotherapy for breast cancer. PURPOSE: This randomized phase III trial is studying goserelin to see how well it works compared with no goserelin in preventing early menopause in premenopausal women undergoing chemotherapy for stage I, stage II, or stage III breast cancer.
OBJECTIVES: Primary * Compare the incidence of premature ovarian failure after chemotherapy in premenopausal women with stage I-III breast cancer treated with goserelin vs no goserelin . Secondary * Compare the quality of life of patients treated with these regimens. * Compare menopausal symptoms in patients treated with these regimens. * Compare bone mineral density loss in patients treated with these regimens. * Compare hormone levels in patients treated with these regimens. * Compare menstruation in patients treated with these regimens. * Compare the incidence of pregnancy in patients treated with these regimens. OUTLINE: This is a randomized, open-label, prospective, parallel group, multicenter study. Patients are stratified according to age (≤ 40 years vs \> 40 years) and participating center. Patients are randomized to 1 of 2 treatment arms. Arm I (chemotherapy alone): Patients receive neoadjuvant or adjuvant cyclophosphamide- and/or anthracycline-containing chemotherapy. Treatment continues for 6-8 courses in the absence of disease progression or unacceptable toxicity. Arm II (chemotherapy plus goserelin for ovarian function suppression): Patients receive neoadjuvant or adjuvant chemotherapy as in arm I. Patients also receive goserelin subcutaneously every 3-4 weeks beginning 1-3 weeks before the start of chemotherapy. Treatment with goserelin repeats every 3-4 weeks until completion of chemotherapy. Quality of life is assessed at baseline, at 3, 6, 12, 18, and 24 months, and then annually for up to 5 years. After completion of study therapy, patients are followed periodically for 5 years. Peer Reviewed and Funded or Endorsed by Cancer Research UK PROJECTED ACCRUAL: A total of 400 patients will be accrued for this study.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
NONE
Enrollment
400
Basingstoke and North Hampshire NHS Foundation Trust
Basingstoke, England, United Kingdom
Royal United Hospital
Bath, England, United Kingdom
Frenchay Hospital
Bristol, England, United Kingdom
Addenbrooke's Hospital
Cambridge, England, United Kingdom
Halton Hospital
Cheshire, England, United Kingdom
Rate of premature menopause, defined as cessation of menses during a course of chemotherapy with no recovery for at least 12 months
Incidence of menopausal symptoms
Quality of life
Bone mineral density loss as measured by dual energy X-ray absorptiometry scans at 12, 24, and 36 months and by serum biomarkers
Hormone levels (including follicle-stimulating hormone, luteinizing hormone, beta-inhibin, and estradiol) as measured after course 3, after course 6 or 8 (depending on chemotherapy regimen), at 9 and 12 months, and then annually for up to 5 years
Menstruation history as measured by patient menstrual diary for 24 months from the start of chemotherapy
Incidence of pregnancy
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