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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/cdn\/css\/http\/css_Xg7z6oCTVgud_Q0huYz9x9iiD5H_2YPSJ5z2ZViSWdY.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EThe addition of goserelin to standard chemotherapy treatment in premenopausal women with hormone receptor-negative breast cancer resulted in a reduced rate of ovarian dysfunction and a greater rate of successful pregnancies. This article presents data from the S0230 Goserelin in Preventing Ovarian Failure in Women Receiving Chemotherapy for Breast Cancer trial [POEMS; \u003Ca class=\u0022external-ref external-ref-type-clintrialgov\u0022 href=\u0022\/lookup\/external-ref?link_type=CLINTRIALGOV\u0026amp;access_num=NCT00068601\u0026amp;atom=%2Fspmdc%2F14%2F14%2F18.atom\u0022\u003ENCT00068601\u003C\/a\u003E; Moore HCF et al. \u003Cem\u003EJ Clin Oncol\u003C\/em\u003E 2014].\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EOncology Clinical Trials\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EBreast Cancer\u003C\/li\u003E\u003C\/ul\u003E\u003Cul class=\u0022kwd-group clinical-trial\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EOncology Clinical Trials\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EBreast Cancer\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EOncology\u003C\/li\u003E\u003C\/ul\u003E\u003Cp id=\u0022p-2\u0022\u003EThe addition of goserelin to standard chemotherapy treatment in premenopausal women with hormone receptor-negative breast cancer resulted in a reduced rate of ovarian dysfunction and a greater rate of successful pregnancies. Halle C. Moore, MD, Cleveland Clinic Taussig Cancer Institute, Cleveland, Ohio, USA, presented data from the S0230 Goserelin in Preventing Ovarian Failure in Women Receiving Chemotherapy for Breast Cancer trial [POEMS; \u003Ca class=\u0022external-ref external-ref-type-clintrialgov\u0022 href=\u0022\/lookup\/external-ref?link_type=CLINTRIALGOV\u0026amp;access_num=NCT00068601\u0026amp;atom=%2Fspmdc%2F14%2F14%2F18.atom\u0022\u003ENCT00068601\u003C\/a\u003E; Moore HCF et al. \u003Cem\u003EJ Clin Oncol\u003C\/em\u003E 2014].\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003EA common complication of chemotherapy is ovarian failure. Interestingly, it has been suggested that ovarian preservation can be attained with luteinizing-hormone releasing hormone (LHRH) agonist treatment during chemotherapy in women with hematologic malignancies; however, randomized trials have produced mixed results and are limited by the end point of returned menses. The purpose of the POEMS trial was to determine pregnancy concomitant with LHRH agonist treatment in women with hormone-receptor negative breast cancer who were treated with chemotherapy and the associated ovarian failure rate and pregnancy outcomes.\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EIn the Phase 3 POEMS trial, 257 premenopausal women with hormone receptor-negative breast cancer were randomly assigned to receive goserelin 3.6 mg subcutaneously every 4 weeks in addition to standard chemotherapy (n=126) or standard cyclophosphamide containing neoadjuvant or adjuvant chemotherapy (n=131). Patients aged 18 to 49 years were eligible if they had operable stage I, II, or IIIA estrogen receptor-negative, progesterone receptor-negative breast cancer but had not received prior estrogen, progesterone, a selective estrogen receptor modulator, or an aromatase inhibitor.\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003EThe primary outcome was ovarian failure at 2 years, which was defined as amenorrhea for 6 months and follicle-stimulating hormone (FSH) levels in the postmenopausal range. Secondary outcomes included ovarian dysfunction at 1 and 2 years and pregnancy outcomes. Disease-free survival (DFS) and overall survival (OS) were exploratory outcomes. Although the target enrollment of 416 patients was not reached before the study closed, the study achieved \u0026gt;80% power to detect an absolute risk reduction in ovarian failure of 15%.\u003C\/p\u003E\u003Cp id=\u0022p-6\u0022\u003EThere was a significant decrease in ovarian failure in patients who received goserelin (8%) compared with patients who received standard chemotherapy alone (22%), even when the data were adjusted for age and chemotherapy regimen (OR, 0.30; 95% CI, 0.09\u20130.97; p=0.04). In addition, goserelin treatment resulted in a reduced rate of ovarian dysfunction at Year 2 (OR, 0.35; 95% CI, 0.13\u20130.93; p=0.03), but not Year 1 (OR, 0.64; 95% CI, 0.30\u20131.37; p=0.25), compared with standard chemotherapy alone.\u003C\/p\u003E\u003Cp id=\u0022p-7\u0022\u003EPregnancy was attempted in 24% and 16% of women in the goserelin versus standard chemotherapy alone arm, respectively (\u003Ca id=\u0022xref-table-wrap-1-1\u0022 class=\u0022xref-table\u0022 href=\u0022#T1\u0022\u003ETable 1\u003C\/a\u003E). Pregnancy was achieved by 21% and 11%, respectively, of women in the goserelin versus standard chemotherapy alone arm (OR, 2.45; p=0.03).\u003C\/p\u003E\u003Cdiv id=\u0022T1\u0022 class=\u0022table pos-float\u0022\u003E\u003Cdiv class=\u0022table-inline\u0022\u003E\u003Cdiv class=\u0022callout\u0022\u003E\u003Cspan\u003EView this table:\u003C\/span\u003E\u003Cul class=\u0022callout-links\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022\/\u0022 class=\u0022table-expand-inline\u0022 data-table-url=\u0022\/highwire\/markup\/14563\/expansion?postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media%2Chighwire_embed\u0026amp;table-expand-inline=1\u0022 html=\u00221\u0022 fragment=\u0022#\u0022 external=\u00221\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView inline\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022\/highwire\/markup\/14563\/expansion?width=1000\u0026amp;height=500\u0026amp;iframe=true\u0026amp;postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media\u0022 class=\u0022colorbox colorbox-load table-expand-popup\u0022 rel=\u0022gallery-fragment-tables\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView popup\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/14563\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022table-caption\u0022\u003E\u003Cspan class=\u0022table-label\u0022\u003ETable 1.\u003C\/span\u003E \n            \u003Cp id=\u0022p-8\u0022 class=\u0022first-child\u0022\u003EEffect of Goserelin on Pregnancy Outcomes in Women Treated for Breast Cancer\u003C\/p\u003E\n         \u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cp id=\u0022p-9\u0022\u003EThe 4-year estimated DFS was 89% in the goserelin arm compared with 78% in the chemotherapy alone arm, resulting in a hazard ratio (HR) of 0.47 (adjusted for age, regimen, and stage; 95% CI, 0.24\u20130.95; p=0.04). The 4-year estimated OS was 92% in the goserelin arm compared with 82% in the chemotherapy alone arm (HR adjusted for age, regimen and stage, 0.43; 95% CI, 0.18\u20131.00; p=0.05). These were exploratory end points and demonstrate that goserelin is at least safe to administer. The reason for improved DFS and OS in the goserlin arm in patients with hormone-receptor negative breast cancer is not well understood.\u003C\/p\u003E\u003Cp id=\u0022p-10\u0022\u003EGrade 3\/4 endocrine toxicity occurred more frequently in the goserelin arm compared with the arm that received chemotherapy alone (p=0.0006). The most common reported adverse events related to goserelin therapy included hot flashes, mood changes, vaginal dryness, and headache. In addition, one grade 4 thromboembolic event occurred.\u003C\/p\u003E\u003Cp id=\u0022p-11\u0022\u003EIn conclusion, Dr. Moore stated that goserelin should be considered in premenopausal women with hormone-receptor negative breast cancer receiving neoadjuvant or adjuvant chemotherapy who are interested in preserving ovarian function.\u003C\/p\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2014 MD Conference Express\u00ae\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/14\/14\/18.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzm1fp\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_tables.js?nzm1fp\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}