Final analysis of the prevention of early menopause study (POEMS)/SWOG intergroup S0230

• Autores: Moore, Halle C.F., Unger, Joseph M., Phillips, Kelly-Anne, Boyle, Frances, Hitre, Erika
• Formato: artículo
• Fecha de Publicación: 2019
• Institución: Instituto Nacional de Enfermedades Neoplásicas
• Repositorio: INEN-Institucional
• Lenguaje: inglés
• OAI Identifier: oai:repositorio.inen.sld.pe:20.500.14703/454
• Enlace del recurso: https: //doi.org/10.1093/jnci/djy185; https://hdl.handle.net/20.500.14703/454
• Nivel de acceso: acceso abierto
• Materia: Adult; Anthracyclines; Antineoplastic Combined Chemotherapy Protocols; Breast Neoplasms; Cyclophosphamide; Female; Follow-Up Studies; Goserelin; Humans; Menopause, Premature; Middle Aged; Pregnancy; Pregnancy Outcome; Primary Ovarian Insufficiency; Receptors, Estrogen; Survival Rate; https://purl.org/pe-repo/ocde/ford#3.02.21

Premature menopause is a serious long-term side effect of chemotherapy. We evaluated long-term pregnancy and disease-related outcomes for patients in S0230/POEMS, a study in premenopausal women with stage I-IIIA estrogen receptor-negative, progesterone receptor-negative breast cancer to be treated with cyclophosphamide-containing chemotherapy. Women were randomly assigned to standard chemotherapy with or without goserelin, a gonadotropin-releasing hormone agonist, and were stratified by age and chemotherapy regimen. All statistical tests were two-sided. Of 257 patients, 218 were eligible and evaluable (105 in the chemotherapy + goserelin arm and 113 in the chemotherapy arm). More patients in the chemotherapy + goserelin arm reported at least one pregnancy vs the chemotherapy arm (5-year cumulative incidence = 23.1%, 95% confidence interval [CI] = 15.3% to 31.9%; and 12.2%, 95% CI = 6.8% to 19.2%, respectively; odds ratio = 2.34; 95% CI = 1.07 to 5.11; P=.03). Randomization to goserelin + chemotherapy was associated with a nonstatistically significant improvement in disease-free survival (hazard ratio [HR] = 0.55; 95% CI = 0.27 to 1.10; P=.09) and overall survival (HR = 0.45; 95% CI = 0.19 to 1.04; P=.06). In this long-term analysis of POEMS/S0230, we found continued evidence that patients randomly assigned to receive goserelin + chemotherapy were not only more likely to avoid premature menopause, but were also more likely to become pregnant without adverse effect on disease-related outcomes.