Short term results from GHRH analogue use in pre-menopausal breast cancer in Korea

Background: Hormone receptor-positive, pre-menopausal breast cancer patients can be treated by chemotherapy and/or ovarian suppression therapy. We reported our experience of gonadotropin-releasing hormone analogue plus tamoxifen (GnRHa + T) or adriamycin and cyclophosphamide (AC) followed by tamoxifen (AC → T) in pre-menopausal women with hormone-response, node-negative breast cancer. Methods: We retrospectively reviewed the records of 587 pre-menopausal women with hormone-responsive, node-negative breast cancer. Of these, 269 were treated with adriamycin and cyclophosphamide (AC) followed by tamoxifen (AC → T), and 318 were treated with gonadotropin-releasing hormone analogue plus tamoxifen (GnRHa + T). Among them, 151 patients were treated by goserelin acetate 3.6 mg/kg and 125 patients were treated by leuprorelin acetate 3.75 mg/kg every 28 days subcutaneously. Findings: At a median follow-up time of 30 months, eight patients had relapsed and three had died. DFS did not differ between the AC → T and GnRHa + T groups. Of the three deaths, two were not related to breast cancer. The third patient, in the AC → T group, died because of brain metastasis. GnRHa + T treatment had no effect on blood profile and did not cause the development of detrimental symptoms but decreased bone mineral density. The efficacy of leuprorelin was similar to that of goserelin. Interpretation: GnRHa + T treatment can be an alternative treatment option in pre-menopausal women with endocrine-responsive, node-negative, breast cancer patients. The efficacy and tolerability of leuprorelin were similar to that of goserelin.