Skip to main content

Advertisement

SpringerLink
Log in

Two different formulations with equivalent effect? Comparison of serum estradiol suppression with monthly goserelin and trimonthly leuprolide in breast cancer patients

  • Original Paper
  • Published:
Medical Oncology Aims and scope Submit manuscript

Abstract

Data comparing the efficacy of monthly and trimonthly formulations of LHRH agonists are lacking. The aim of this study was to compare the effects of monthly goserelin and trimonthly leuprolide on estradiol levels. A total of 79 early breast cancer patients receiving LHRH agonists for at least 6 months were enrolled in the study. Serum estradiol, FSH and LH levels were measured before drug injection and at the one-month follow-up visit. Thirty-eight patients were treated with goserelin, and 41 patients were treated with leuprolide. Patient characteristics and histopathological variables did not differ between the groups. A comparison of the mean hormone levels between the two groups revealed no significant differences in FSH or estradiol levels (p = 0.143 and p = 0.683, respectively), but the median LH level was higher in the leuprolide group (p = 0.025). Among the patients who did not receive chemotherapy, LH levels were higher in the leuprolide arm (p = 0.028). Additionally, FSH levels were significantly higher in the patients over 40 years old (p = 0.02) and in those with tumours harbouring cERB-B2 receptor (p = 0.05) in the leuprolide group. Three patients (7.9 %) in the goserelin and five patients (12.2 %) in the leuprolide group failed to achieve postmenopausal estradiol levels (p = 0.707). The effects of monthly goserelin and trimonthly leuprolide on estradiol levels did not differ significantly. Further research is required to interpret the variable effects on gonadotropins in each subgroup and the relationship between LHRH agonists and survival.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Jemal A, Siegel R, Ward E, Hao Y, Xu J, Murray T, Thun MJ. Cancer statistics, 2008. CA Cancer J Clin. 2008;58:71–96.

    Article  PubMed  Google Scholar 

  2. Early Breast Cancer Trialists’ Collaborative Group (EBCTCG). Effects of chemotherapy and hormonal therapy for early breast cancer on recurrence and 15-year survival: an overview of the randomised trials. Lancet 2005; 365: 1687–1717.

    Google Scholar 

  3. Jemal A, Siegel R, Xu J, Ward E. Cancer statistics, 2010. CA Cancer J Clin. 2010;60:277–300.

    Article  PubMed  Google Scholar 

  4. Gelber RD, Cole BF, Goldhirsch A, Rose C, Fisher B, Osborne CK, Boccardo F, Gray R, Gordon NH, Bengtsson NO, Sevelda P. Adjuvant chemotherapy plus tamoxifen compared with tamoxifen alone for postmenopausal breast cancer: meta-analysis of quality adjusted survival. Lancet. 1996;347:1066–71.

    Article  PubMed  CAS  Google Scholar 

  5. Conn PM, Crowley W. Gonadotropin-releasing hormone and its analogues. N Engl J Med. 1990;324:93–103.

    Google Scholar 

  6. Cockshott ID. Clinical pharmacokinetics of goserelin. Clin Pharmacokinet. 2000;39:27–48.

    Article  PubMed  CAS  Google Scholar 

  7. Klijn JG, Blarney RW, Boccardo F, Tominaga T, Duchateau L, Slyvester R. Combined tamoxifen and lutenizing hormone releasing hormone (LHRH) agonist alone in premenopausal advanced breast cancer: a meta-analysis of four randomized trials. J Clin Oncol. 2001;19:343–53.

    PubMed  CAS  Google Scholar 

  8. Jonat W, Kaufmann M, Sauerbrei W, et al. Goserelin versus cyclophosphamide, methotrexate, and fluorouracil as adjuvant therapy in premenopausal patients with node-positive breast cancer. The Zoladex Early Breast Cancer Research Association Study. J Clin Oncol. 2002;20:4628–35.

    Article  PubMed  CAS  Google Scholar 

  9. Boccardo F, Rubagotti A, Amoroso D, et al. Endocrinological and clinical evaluation of two depot formulations of leuprolide acetate in pre- and perimenopausal breast cancer patients. Cancer Chemother Pharmacol. 1999;43:461–6.

    Article  PubMed  CAS  Google Scholar 

  10. Dowsett M, Jacobs S, Aherne J, Smith IE. Clinical and endocrine effects of leuproreline acetate in pre- and postmenopausal patients with advanced breast cancer. Clin Ther. 1992;14(Suppl A):97–103.

    PubMed  Google Scholar 

  11. Elston CW, Ellis IO. Pathological prognostic factors in breast cancers. The value of histological grade in breast cancer: experience from a large study with long-term follow-up. Histopathology. 1991;19:403–10.

    Article  PubMed  CAS  Google Scholar 

  12. http://www.nccn.org/professionals/physician_gls/pdf/breast.pdf. NCCN guidelines version 1.2012. Breast Cancer. Definition of menopause.

  13. Early Breast Cancer Trialists’ Cooperative Group. Ovarian ablation in early breast cancer: overview of randomized trials. Lancet. 2005;365:1687–717.

    Article  Google Scholar 

  14. Davidson NE, O’Neill AM, Vukov AM, Osborne CK, Martino S, White DR, Abeloff MD. Chemoendocrine therapy for premenopausal women with axillary lymph node-positive, steroid hormone receptor-positive breast cancer: results from INT 0101 (E5188). J Clin Oncol. 2005;23:5973–82.

    Article  PubMed  CAS  Google Scholar 

  15. Arriagada R, Le MG, Spielmann M, Mauriac L, Bonneterre J, Namer M, Delozier T, Hill C, Tursz T. Randomized trial of adjuvant ovarian suppression in 926 premenopausal patients with early breast cancer treated with adjuvant chemotherapy. Ann Oncol. 2005;16:389–96.

    Article  PubMed  CAS  Google Scholar 

  16. Baum M, Hackshaw A, Houghton J, Rutqvist LE, Fornander T, Nordenskjold B, Nicollucci A, Sainsbury R. Adjuvant goserelin in pre-menopausal patients with early breast cancer patients: results from the ZIPP study. Eur J Cancer. 2006;42:895–904.

    Article  PubMed  CAS  Google Scholar 

  17. Goldhirsch A, Wood WC, Coates AS, Gelber RD, Thürlimann B, Senn HJ. Strategies for subtypes–dealing with the diversity of breast cancer: highlights of the St. Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2011. Ann Oncol. 2011;22:1736–42.

    Article  PubMed  CAS  Google Scholar 

  18. Thomas EJ, Jenkins J, Lenton EA, Cooke ID. Endocrine effects of goserelin, a new depot luteinising hormone releasing agonist. Br Med J (Clin Res Ed). 1986;293:1407–8.

    Article  CAS  Google Scholar 

  19. West CP, Baird DT. Suppression of ovarian activity by Zoladex depot (ICI 118630), a long-acting luteinizing hormone releasing agonist analogue. Clin Endocrinol (Oxf). 1987;26:213–20.

    Article  CAS  Google Scholar 

  20. Cockshott ID. Clinical pharmacokinetics of goserelin. Clin Pharmacokinet. 2000;39:27–48.

    Article  PubMed  CAS  Google Scholar 

  21. Yri OE, Bjoro T, Fossa SD. Failure to achieve castration levels in patients using leuprolide acetate in locally advanced prostate cancer. Eur Urol. 2006;49:54–8.

    Article  PubMed  CAS  Google Scholar 

  22. Fujii Y, Yonese J, Kawakami S, Yamamoto S, Okubo Y, Fukui I. Equivalent and sufficient effects of leuprolide acetate and goserelin acetate to suppress serum testosterone levels in patients with prostate cancer. BJU Int. 2008;101:1096–100.

    Article  PubMed  CAS  Google Scholar 

  23. Masuda N, Iwata H, Rai Y, Anan K, Takeuchi T, Kohno N, Takei H, Yanagita Y, Noguchi S. Monthly versus 3-monthly goserelin acetate in pre-menopausal patients with estrogen receptor-positive early breast cancer. Breast Cancer Res Treat. 2011;126:443–51.

    Article  PubMed  CAS  Google Scholar 

  24. Perachino M, Cavalli V, Bravi F. Testosterone levels in patients with metastatic prostate cancer treated with luteinizing hormone-releasing hormone therapy: prognostic significance? BJU Int. 2009;105:648–51.

    Article  PubMed  Google Scholar 

  25. Dowsett M, Houghton J, Iden C, Salter J, Farndon J, A’Hern R, Sainsbury R, Baurn M. Benefit from adjuvant tamoxifen therapy in primary breast cancer patients according oestrogen receptor, progesterone receptor, EGF receptor and HER2 status. Ann Oncol. 2006;17:818–26.

    Article  PubMed  CAS  Google Scholar 

Download references

Conflict of interest

The authors declare that they have no conflict of interest and the interventions involved in the study comply with the current laws of Turkey.

Author information

Authors and Affiliations

  1. Department of Medical Oncology, Institute of Oncology, Istanbul University, Capa, Istanbul, Turkey

    Adnan Aydiner, Leyla Kilic, Ibrahim Yildiz, Serkan Keskin & Fatma Sen

  2. Department of Radiation Oncology, Institute of Oncology, Istanbul University, Capa, Istanbul, Turkey

    Seden Kucucuk

  3. Department of Surgery, Institute of Oncology, Istanbul University, Capa, Istanbul, Turkey

    Hasan Karanlik

  4. Department of General Surgery, Istanbul Medical Faculty, Istanbul University, Capa, Istanbul, Turkey

    Mahmut Muslumanoglu & Abdullah Igci

Authors
  1. Adnan Aydiner
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Leyla Kilic
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ibrahim Yildiz
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Serkan Keskin
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Fatma Sen
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Seden Kucucuk
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Hasan Karanlik
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Mahmut Muslumanoglu
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Abdullah Igci
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding authors

Correspondence to Adnan Aydiner or Leyla Kilic.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Aydiner, A., Kilic, L., Yildiz, I. et al. Two different formulations with equivalent effect? Comparison of serum estradiol suppression with monthly goserelin and trimonthly leuprolide in breast cancer patients. Med Oncol 30, 354 (2013). https://doi.org/10.1007/s12032-012-0354-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s12032-012-0354-1

Keywords

Search

Navigation