Final Analysis of the Prevention of Early Menopause Study (POEMS)/SWOG Intergroup S0230

• Autores: Moore, HCF, Unger, JM, Phillips, KA, Boyle, F, Hitre, E, Moseley, A, Porter, DJ, Francis, PA, Goldstein, LJ, Gomez-Moreno, HL, Vallejos-Sologuren, CS, Partridge, AH, Dakhil, SR, Garcia, AA, Gralow, JR, Lombard, JM, Forbes, JF, Martino, S, Barlow, WE, Fabian, CJ, Minasian, LM, Meyskens, FL, Gelber, RD, Hortobagyi, GN, Albain, KS
• Formato: artículo
• Fecha de Publicación: 2019
• Institución: Instituto Nacional de Enfermedades Neoplásicas
• Repositorio: INEN-Institucional
• Lenguaje: inglés
• OAI Identifier: oai:repositorio.inen.sld.pe:inen/125
• Enlace del recurso: https://repositorio.inen.sld.pe/handle/inen/125
• Nivel de acceso: acceso abierto
• Materia: 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.