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. 1995 May;71(5):1111–1114. doi: 10.1038/bjc.1995.215

Combination goserelin and tamoxifen therapy in premenopausal advanced breast cancer: a multicentre study by the ITMO group. Italian Trials in Medical Oncology.

R Buzzoni 1, L Biganzoli 1, E Bajetta 1, L Celio 1, A Fornasiero 1, L Mariani 1, N Zilembo 1, M Di Bartolomeo 1, A Di Leo 1, G Arcangeli 1, et al.
PMCID: PMC2033795  PMID: 7734310

Abstract

It has been suggested that tamoxifen may improve the efficacy of medical castration with luteinising hormone-releasing hormone analogues, but very few data have so far been published concerning the clinical and endocrinological activity of this therapeutic modality. In this phase II multicentre trial conducted by the Italian Trials in Medical Oncology group (ITMO), 64 premenopausal patients with hormone receptor-positive or unknown breast cancer were treated with monthly s.c. injections of goserelin 3.6 mg, in association with a tamoxifen daily dose of 20 mg, as first-line therapy for their advanced disease. All of the patients were evaluable for efficacy and there was an overall response rate of 41% (95% confidence interval 28-52%), with 7 of the 26 responders achieving complete remission. The median time to response was 4 months (range 2-17), and the median response duration was 13 months (range 6-37 +). Better responses were observed in soft tissues (51%); the response in visceral and bone metastases was respectively 19% and 37%. Serum concentrations of gonadotrophins and oestradiol were significantly decreased by the treatment, oestrogen levels being constantly suppressed to within the range observed in post-menopausal women. No significant change was detected in serum testosterone levels. In our experience, although it was not associated with any increased clinical efficacy, the concurrent use of goserelin and tamoxifen proved to be a feasible approach in the management of premenopausal advanced breast cancer.

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Selected References

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  1. Bajetta E., Celio L., Zilembo N., Bono A., Galluzzo D., Zampino M. G., Longhi A., Ferrari L., Buzzoni R. Ovarian function suppression with the gonadotrophin-releasing hormone (GnRH) analogue goserelin in premenopausal advanced breast cancer. Tumori. 1994 Feb 28;80(1):28–32. doi: 10.1177/030089169408000105. [DOI] [PubMed] [Google Scholar]
  2. Bajetta E., Zilembo N., Buzzoni R., Celio L., Zampino M. G., Colleoni M., Oriana S., Attili A., Sacchini V., Martinetti A. Goserelin in premenopausal advanced breast cancer: clinical and endocrine evaluation of responsive patients. Oncology. 1994 May-Jun;51(3):262–269. doi: 10.1159/000227346. [DOI] [PubMed] [Google Scholar]
  3. Beksaç M. S., Kişnişci H. A., Cakar A. N., Beksaç M. The endocrinological evaluation of bilateral and unilateral oophorectomy in premenopausal women. Int J Fertil. 1983;28(4):219–224. [PubMed] [Google Scholar]
  4. Blamey R. W., Jonat W., Kaufmann M., Bianco A. R., Namer M. Goserelin depot in the treatment of premenopausal advanced breast cancer. Eur J Cancer. 1992;28A(4-5):810–814. doi: 10.1016/0959-8049(92)90120-q. [DOI] [PubMed] [Google Scholar]
  5. Buchanan R. B., Blamey R. W., Durrant K. R., Howell A., Paterson A. G., Preece P. E., Smith D. C., Williams C. J., Wilson R. G. A randomized comparison of tamoxifen with surgical oophorectomy in premenopausal patients with advanced breast cancer. J Clin Oncol. 1986 Sep;4(9):1326–1330. doi: 10.1200/JCO.1986.4.9.1326. [DOI] [PubMed] [Google Scholar]
  6. Dixon A. R., Jackson L., Robertson J. F., Nicholson R. I., Blamey R. W. Combined goserelin and tamoxifen in premenopausal advanced breast cancer: duration of response and survival. Eur J Cancer. 1991;27(6):806–807. doi: 10.1016/0277-5379(91)90197-l. [DOI] [PubMed] [Google Scholar]
  7. Dixon A. R., Robertson J. F., Jackson L., Nicholson R. I., Walker K. J., Blamey R. W. Goserelin (Zoladex) in premenopausal advanced breast cancer: duration of response and survival. Br J Cancer. 1990 Nov;62(5):868–870. doi: 10.1038/bjc.1990.397. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Harvey H. A., Lipton A., Max D. T., Pearlman H. G., Diaz-Perches R., de la Garza J. Medical castration produced by the GnRH analogue leuprolide to treat metastatic breast cancer. J Clin Oncol. 1985 Aug;3(8):1068–1072. doi: 10.1200/JCO.1985.3.8.1068. [DOI] [PubMed] [Google Scholar]
  9. Hayward J. L., Carbone P. P., Heusen J. C., Kumaoka S., Segaloff A., Rubens R. D. Assessment of response to therapy in advanced breast cancer. Br J Cancer. 1977 Mar;35(3):292–298. doi: 10.1038/bjc.1977.42. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Klijn J. G., de Jong F. H. Treatment with a luteinising-hormone-releasing-hormone analogue (buserelin) in premenopausal patients with metastatic breast cancer. Lancet. 1982 May 29;1(8283):1213–1216. doi: 10.1016/s0140-6736(82)92339-x. [DOI] [PubMed] [Google Scholar]
  11. Manni A., Pearson O. H. Antiestrogen-induced remissions in premenopausal women with stage IV breast cancer: effects on ovarian function. Cancer Treat Rep. 1980 Jun-Jul;64(6-7):779–785. [PubMed] [Google Scholar]
  12. Matta W. H., Shaw R. W., Burford G. D. Endocrinologic and clinical evaluation following a single administration of a gonadotrophin-releasing hormone agonist (Zoladex), in a depot formulation, to premenopausal women. Fertil Steril. 1988 Jan;49(1):163–165. doi: 10.1016/s0015-0282(16)59670-8. [DOI] [PubMed] [Google Scholar]
  13. Ribeiro G., Swindell R. The Christie hospital adjuvant tamoxifen trial--status at 10 years. Br J Cancer. 1988 Jun;57(6):601–603. doi: 10.1038/bjc.1988.136. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Santen R. J. Clinical use of aromatase inhibitors: current data and future perspectives. J Enzyme Inhib. 1990;4(2):79–99. doi: 10.3109/14756369009040730. [DOI] [PubMed] [Google Scholar]
  15. Santen R. J., Manni A., Harvey H. Gonadotropin releasing hormone (GnRH) analogs for the treatment of breast and prostatic carcinoma. Breast Cancer Res Treat. 1986;7(3):129–145. doi: 10.1007/BF01806244. [DOI] [PubMed] [Google Scholar]
  16. Simon R. Optimal two-stage designs for phase II clinical trials. Control Clin Trials. 1989 Mar;10(1):1–10. doi: 10.1016/0197-2456(89)90015-9. [DOI] [PubMed] [Google Scholar]
  17. Sunderland M. C., Osborne C. K. Tamoxifen in premenopausal patients with metastatic breast cancer: a review. J Clin Oncol. 1991 Jul;9(7):1283–1297. doi: 10.1200/JCO.1991.9.7.1283. [DOI] [PubMed] [Google Scholar]
  18. Walker K. J., Walker R. F., Turkes A., Robertson J. F., Blamey R. W., Griffiths K., Nicholson R. I. Endocrine effects of combination antioestrogen and LH-RH agonist therapy in premenopausal patients with advanced breast cancer. Eur J Cancer Clin Oncol. 1989 Apr;25(4):651–654. doi: 10.1016/0277-5379(89)90200-9. [DOI] [PubMed] [Google Scholar]
  19. van Leeuwen F. E., Benraadt J., Coebergh J. W., Kiemeney L. A., Gimbrère C. H., Otter R., Schouten L. J., Damhuis R. A., Bontenbal M., Diepenhorst F. W. Risk of endometrial cancer after tamoxifen treatment of breast cancer. Lancet. 1994 Feb 19;343(8895):448–452. doi: 10.1016/s0140-6736(94)92692-1. [DOI] [PubMed] [Google Scholar]

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