Interaction between goserelin and tamoxifen in a prospective randomised clinical trial of adjuvant endocrine therapy in premenopausal breast cancer.

2.50
Hdl Handle:
http://hdl.handle.net/2336/226401
Title:
Interaction between goserelin and tamoxifen in a prospective randomised clinical trial of adjuvant endocrine therapy in premenopausal breast cancer.
Authors:
Sverrisdottir, Asgerdur; Johansson, Hemming; Johansson, Ulla; Bergh, Jonas; Rotstein, Samuel; Rutqvist, Larserik; Fornander, Tommy
Citation:
Breast Cancer Res. Treat. 2011, 128(3):755-63
Issue Date:
Aug-2011
Abstract:
Ovarian ablation improves survival in premenopausal early breast cancer, but the potential added value by luteinizing hormone-releasing hormone (LHRH) agonists to tamoxifen is still not clear. The purpose of our study is to examine the efficacy of the LHRH agonist goserelin for adjuvant therapy of premenopausal breast cancer, the role of interaction between goserelin and tamoxifen and the impact of estrogen receptor (ER) content. A total of 927 patients were included in the Stockholm part of the Zoladex in Premenopausal Patients (ZIPP) trial. They were randomly allocated in a 2 × 2 factorial study design to goserelin, tamoxifen, the combination of goserelin and tamoxifen or no endocrine therapy for 2 years, with or without chemotherapy. This is formally not a preplanned subset analysis presenting the end point first event. In this Stockholm sub-study, at a median follow-up of 12.3 years, goserelin reduced the risk of first event by 32% (P = 0.005) in the absence of tamoxifen, and tamoxifen reduced the risk by 27% (P = 0.018) in the absence of goserelin. The combined goserelin and tamoxifen treatment reduced the risk by 24% (P = 0.021) compared with no endocrine treatment. In highly ER-positive tumours, there were 29% fewer events among goserelin treated (P = 0.044) and a trend towards greater risk reduction depending on the level of ER content. The greatest risk reduction from goserelin treatment was observed among those not receiving tamoxifen (HR: 0.52, P = 0.007). In conclusion, goserelin as well as tamoxifen reduces the risk of recurrence in endocrine responsive premenopausal breast cancer. Women with strongly ER-positive tumours may benefit more from goserelin treatment. The combination of goserelin and tamoxifen is not superior to either modality alone. With the limitations of a subset trial, these data have to be interpreted cautiously.
Description:
To access publisher full text version of this article. Please click on the hyperlink in Additional Links field.
Additional Links:
http://dx.doi.org/10.1007/s10549-011-1593-0
Rights:
Archived with thanks to Breast cancer research and treatment

Full metadata record

DC FieldValue Language
dc.contributor.authorSverrisdottir, Asgerduren_GB
dc.contributor.authorJohansson, Hemmingen_GB
dc.contributor.authorJohansson, Ullaen_GB
dc.contributor.authorBergh, Jonasen_GB
dc.contributor.authorRotstein, Samuelen_GB
dc.contributor.authorRutqvist, Larseriken_GB
dc.contributor.authorFornander, Tommyen_GB
dc.date.accessioned2012-05-29T11:41:40Z-
dc.date.available2012-05-29T11:41:40Z-
dc.date.issued2011-08-
dc.date.submitted2012-05-29-
dc.identifier.citationBreast Cancer Res. Treat. 2011, 128(3):755-63en_GB
dc.identifier.issn1573-7217-
dc.identifier.pmid21625929-
dc.identifier.doi10.1007/s10549-011-1593-0-
dc.identifier.urihttp://hdl.handle.net/2336/226401-
dc.descriptionTo access publisher full text version of this article. Please click on the hyperlink in Additional Links field.en_GB
dc.description.abstractOvarian ablation improves survival in premenopausal early breast cancer, but the potential added value by luteinizing hormone-releasing hormone (LHRH) agonists to tamoxifen is still not clear. The purpose of our study is to examine the efficacy of the LHRH agonist goserelin for adjuvant therapy of premenopausal breast cancer, the role of interaction between goserelin and tamoxifen and the impact of estrogen receptor (ER) content. A total of 927 patients were included in the Stockholm part of the Zoladex in Premenopausal Patients (ZIPP) trial. They were randomly allocated in a 2 × 2 factorial study design to goserelin, tamoxifen, the combination of goserelin and tamoxifen or no endocrine therapy for 2 years, with or without chemotherapy. This is formally not a preplanned subset analysis presenting the end point first event. In this Stockholm sub-study, at a median follow-up of 12.3 years, goserelin reduced the risk of first event by 32% (P = 0.005) in the absence of tamoxifen, and tamoxifen reduced the risk by 27% (P = 0.018) in the absence of goserelin. The combined goserelin and tamoxifen treatment reduced the risk by 24% (P = 0.021) compared with no endocrine treatment. In highly ER-positive tumours, there were 29% fewer events among goserelin treated (P = 0.044) and a trend towards greater risk reduction depending on the level of ER content. The greatest risk reduction from goserelin treatment was observed among those not receiving tamoxifen (HR: 0.52, P = 0.007). In conclusion, goserelin as well as tamoxifen reduces the risk of recurrence in endocrine responsive premenopausal breast cancer. Women with strongly ER-positive tumours may benefit more from goserelin treatment. The combination of goserelin and tamoxifen is not superior to either modality alone. With the limitations of a subset trial, these data have to be interpreted cautiously.en_GB
dc.description.sponsorshipSwedish Cancer Society King Gustav V Jubilee Fund Swedish Research Fund Stockholm Cancer Society Swedish Breast Cancer Association (BRO) Karolinska Instituet Stockholm County Council Research Strategy Initiative Marit and Hans Rausing's Initiative Against Breast Canceren_GB
dc.language.isoenen
dc.relation.urlhttp://dx.doi.org/10.1007/s10549-011-1593-0en_GB
dc.rightsArchived with thanks to Breast cancer research and treatmenten_GB
dc.titleInteraction between goserelin and tamoxifen in a prospective randomised clinical trial of adjuvant endocrine therapy in premenopausal breast cancer.en
dc.typeArticleen
dc.contributor.departmentDepartment of Oncology, Karolinska Institutet and University Hospital, Stockholm, Sweden. asgerds@landspitali.isen_GB
dc.identifier.journalBreast cancer research and treatmenten_GB
All Items in Hirsla are protected by copyright, with all rights reserved, unless otherwise indicated.