Is goserelin treatment with chemotherapy effective in premenopausal patients?

This study aimed to determine the effectiveness of goserelin (Zoladex) treatment with chemotherapy in young breast cancer patients. The study concluded that goserelin treatment with chemotherapy improved pathological complete response (pCR) rates. 

A long-term and potentially devastating effect of chemotherapy can be early ovarian failure. The ovaries are required to produce an egg. Therefore, if the ovaries stop working the result is infertility. GnRH agonists, such as goserelin, are treatments that block ovulation. Goserelin is thought to be able to protect the ovaries in some patients who are undergoing chemotherapy. It is not clear whether combining goserelin with chemotherapy improves cancer response rates.   

This study examined the records 332 cases of invasive breast cancer.  The patients were less than 40 years of age when they were diagnosed. The patients had received either goserelin treatment with chemotherapy or chemotherapy alone. These treatments were offered in order to shrink the size of the tumors prior to surgery. Pathological complete response rates (the absence of cancer cells in tissue examined after surgery) were measured.

Patients treated with goserelin and chemotherapy were 2.98 times as likely to have a higher pCR rate. Patients with tumors not dependent on hormones (such as estrogen) for growth were 3.5 times more likely to have a higher pCR rate following goserelin treatment than chemotherapy alone.

Goserelin and chemotherapy also led to a significantly larger decrease in cancer cell multiplication than did chemotherapy alone. 

The study concluded that goserelin treatment with chemotherapy improved pCR rates, especially in hormone receptor negative patients.

A limitation of this study was the small number of patients included in the study.