GnRH Agonists With Chemo for Breast Cancer May Restore Regular Menses

Gonadotropin-releasing hormone (GnRH) agonists administered with chemotherapy was associated with increased rates of recovery of regular menses in premenopausal women with early-stage breast cancer, a new study published online in JAMA Oncology has shown.¹

Because chemotherapy may negatively impact ovarian function and fertility in premenopausal women undergoing treatment for early-stage breast cancer, researchers sought to determine the effectiveness of GnRH agonists, which have been suggested to prevent the loss of ovarian function due to cytotoxic agents, administered concurrently with chemotherapy for the preservation of ovarian function.

For the meta-analysis, researchers analyzed data from 7 prospective, randomized, clinical trials that included a total of 856 evaluable patients with early-stage breast cancer.

Results showed that the use of GnRH agonists was associated with a higher rate of recovery of regular menses after 6 months (OR = 2.41; 95% CI: 1.40, 4.15; P = .002) and at least 12 months (OR = 1.85; 95% CI: 1.33, 2.59; P < .001) after the last chemotherapy cycle.

Researchers found that the use of GnRH agonists was also associated with a higher number of pregnancies (OR = 1.85; 95% CI: 1.02, 3.36; P = .04); however, this outcome was not consistent among all trials evaluated.

“Evidence was insufficient to assess outcomes related to GnRH [agonists] and ovarian function and fertility and needs further investigation,” the authors concluded.

Reference

1. Munhoz RR, Peteira AAL, Sasse AD, et al. Gonadotropin-releasing hormone agonists for ovarian function preservation in premenopausal women undergoing chemotherapy for early-stage breast cancer [published online ahead of print on October 1, 2015]. JAMA Oncol. doi: 10.1001/jamaoncol.2015.3251.