Goserelin versus cyclophosphamide, methotrexate, and fluorouracil as adjuvant therapy in premenopausal patients with node-positive breast cancer: The Zoladex Early Breast Cancer Research Association Study.

2.50
Hdl Handle:
http://hdl.handle.net/10541/81114
Title:
Goserelin versus cyclophosphamide, methotrexate, and fluorouracil as adjuvant therapy in premenopausal patients with node-positive breast cancer: The Zoladex Early Breast Cancer Research Association Study.
Authors:
Jonat, W; Kaufmann, M; Sauerbrei, W; Blamey, R; Cuzick, J; Namer, M; Fogelman, I; De Haes, J; De Matteis, A; Stewart, Alan L; Eiermann, Wolfgang; Szakolczai, I; Palmer, Michael K; Schumacher, M; Geberth, M; Lisboa, B
Abstract:
PURPOSE: Current adjuvant therapies have improved survival for premenopausal patients with breast cancer but may have short-term toxic effects and long-term effects associated with premature menopause. PATIENTS AND METHODS: The Zoladex Early Breast Cancer Research Association study assessed the efficacy and tolerability of goserelin (3.6 mg every 28 days for 2 years; n = 817) versus cyclophosphamide, methotrexate, and fluorouracil (CMF) chemotherapy (six 28-day cycles; n = 823) for adjuvant treatment in premenopausal patients with node-positive breast cancer. RESULTS: Analysis was performed when 684 events had been achieved, and the median follow-up was 6 years. A significant interaction between treatment and estrogen receptor (ER) status was found (P =.0016). In ER-positive patients (approximately 74%), goserelin was equivalent to CMF for disease-free survival (DFS) (hazard ratio [HR], 1.01; 95% confidence interval [CI], 0.84 to 1.20). In ER-negative patients, goserelin was inferior to CMF for DFS (HR, 1.76; 95% CI, 1.27 to 2.44). Amenorrhea occurred in more than 95% of goserelin patients by 6 months versus 58.6% of CMF patients. Menses returned in most goserelin patients after therapy stopped, whereas amenorrhea was generally permanent in CMF patients (22.6% v 76.9% amenorrheic at 3 years). Chemotherapy-related side effects such as nausea/vomiting, alopecia, and infection were higher with CMF than with goserelin during CMF treatment. Side effects related to estrogen suppression were initially higher with goserelin, but when goserelin treatment stopped, reduced to a level below that observed in the CMF group. CONCLUSION: Goserelin offers an effective, well-tolerated alternative to CMF in premenopausal patients with ER-positive and node-positive early breast cancer.
Affiliation:
Klinik fur Gynakologie und Gerburtshilfe, University of Kiel, Germany. jonat@email.uni-kiel.de
Citation:
Goserelin versus cyclophosphamide, methotrexate, and fluorouracil as adjuvant therapy in premenopausal patients with node-positive breast cancer: The Zoladex Early Breast Cancer Research Association Study. 2002, 20 (24):4628-35 J. Clin. Oncol.
Journal:
Journal of Clinical Oncology
Issue Date:
15-Dec-2002
URI:
http://hdl.handle.net/10541/81114
PubMed ID:
12488406
Type:
Article
Language:
en
ISSN:
0732-183X
Appears in Collections:
All Christie Publications

Full metadata record

DC FieldValue Language
dc.contributor.authorJonat, W-
dc.contributor.authorKaufmann, M-
dc.contributor.authorSauerbrei, W-
dc.contributor.authorBlamey, R-
dc.contributor.authorCuzick, J-
dc.contributor.authorNamer, M-
dc.contributor.authorFogelman, I-
dc.contributor.authorDe Haes, J-
dc.contributor.authorDe Matteis, A-
dc.contributor.authorStewart, Alan L-
dc.contributor.authorEiermann, Wolfgang-
dc.contributor.authorSzakolczai, I-
dc.contributor.authorPalmer, Michael K-
dc.contributor.authorSchumacher, M-
dc.contributor.authorGeberth, M-
dc.contributor.authorLisboa, B-
dc.date.accessioned2009-09-15T13:43:11Z-
dc.date.available2009-09-15T13:43:11Z-
dc.date.issued2002-12-15-
dc.identifier.citationGoserelin versus cyclophosphamide, methotrexate, and fluorouracil as adjuvant therapy in premenopausal patients with node-positive breast cancer: The Zoladex Early Breast Cancer Research Association Study. 2002, 20 (24):4628-35 J. Clin. Oncol.en
dc.identifier.issn0732-183X-
dc.identifier.pmid12488406-
dc.identifier.urihttp://hdl.handle.net/10541/81114-
dc.description.abstractPURPOSE: Current adjuvant therapies have improved survival for premenopausal patients with breast cancer but may have short-term toxic effects and long-term effects associated with premature menopause. PATIENTS AND METHODS: The Zoladex Early Breast Cancer Research Association study assessed the efficacy and tolerability of goserelin (3.6 mg every 28 days for 2 years; n = 817) versus cyclophosphamide, methotrexate, and fluorouracil (CMF) chemotherapy (six 28-day cycles; n = 823) for adjuvant treatment in premenopausal patients with node-positive breast cancer. RESULTS: Analysis was performed when 684 events had been achieved, and the median follow-up was 6 years. A significant interaction between treatment and estrogen receptor (ER) status was found (P =.0016). In ER-positive patients (approximately 74%), goserelin was equivalent to CMF for disease-free survival (DFS) (hazard ratio [HR], 1.01; 95% confidence interval [CI], 0.84 to 1.20). In ER-negative patients, goserelin was inferior to CMF for DFS (HR, 1.76; 95% CI, 1.27 to 2.44). Amenorrhea occurred in more than 95% of goserelin patients by 6 months versus 58.6% of CMF patients. Menses returned in most goserelin patients after therapy stopped, whereas amenorrhea was generally permanent in CMF patients (22.6% v 76.9% amenorrheic at 3 years). Chemotherapy-related side effects such as nausea/vomiting, alopecia, and infection were higher with CMF than with goserelin during CMF treatment. Side effects related to estrogen suppression were initially higher with goserelin, but when goserelin treatment stopped, reduced to a level below that observed in the CMF group. CONCLUSION: Goserelin offers an effective, well-tolerated alternative to CMF in premenopausal patients with ER-positive and node-positive early breast cancer.en
dc.language.isoenen
dc.subjectBreast Canceren
dc.subjectOestrogen Receptorsen
dc.subject.meshAmenorrhea-
dc.subject.meshAntineoplastic Combined Chemotherapy Protocols-
dc.subject.meshBreast Neoplasms-
dc.subject.meshChemotherapy, Adjuvant-
dc.subject.meshCyclophosphamide-
dc.subject.meshDisease-Free Survival-
dc.subject.meshFemale-
dc.subject.meshFluorouracil-
dc.subject.meshFollow-Up Studies-
dc.subject.meshGoserelin-
dc.subject.meshHumans-
dc.subject.meshLymph Nodes-
dc.subject.meshLymphatic Metastasis-
dc.subject.meshMethotrexate-
dc.subject.meshMiddle Aged-
dc.subject.meshPremenopause-
dc.subject.meshReceptors, Estrogen-
dc.titleGoserelin versus cyclophosphamide, methotrexate, and fluorouracil as adjuvant therapy in premenopausal patients with node-positive breast cancer: The Zoladex Early Breast Cancer Research Association Study.en
dc.typeArticleen
dc.contributor.departmentKlinik fur Gynakologie und Gerburtshilfe, University of Kiel, Germany. jonat@email.uni-kiel.deen
dc.identifier.journalJournal of Clinical Oncologyen

Related articles on PubMed

All Items in Christie are protected by copyright, with all rights reserved, unless otherwise indicated.