Breast Cancer Research and Treatment

, Volume 171, Issue 1, pp 245–246 | Cite as

Treatment-induced early menopause and the protective role of gonadotropin-releasing hormone agonists during chemotherapy

  • Francesca Poggio
  • Benedetta Conte
  • Matteo LambertiniEmail author
Letter to the Editor

To the Editor,

We read with great interest the recently published article by Zhang and colleagues reporting the results of their randomized phase III trial investigating the efficacy and safety of concurrent versus sequential administration of chemotherapy and the gonadotropin-releasing hormone agonist (GnRHa) goserelin in premenopausal women with estrogen receptor-positive breast cancer [1]. This study aimed at comparing the survival outcomes and the incidence of treatment-induced early menopause (defined as amenorrhea and postmenopausal levels of follicle-stimulating hormone and estradiol 1 year after the last GnRHa dose) between patients who received GnRHa for a duration of at least 2 years concurrently or sequentially to (neo)adjuvant chemotherapy. Among the 216 included patients, after a median follow-up of 56.9 months, no significant difference in disease-free survival (adjusted hazard ratio [HR] 1.52, 95% confidence intervals [CI] 0.80–2.86; p = 0.201) and overall survival...


Compliance with ethical standards

Conflict of interest

Matteo Lambertini acknowledges the support from the European Society for Medical Oncology (ESMO) for a Translational Research Fellowship at Institut Jules Bordet, Brussels, Belgium, and he served as a consultant for Teva outside the submitted work. The other authors declare no conflict of interest in relation to this article.

Ethical approval

Not applicable.


  1. 1.
    Zhang Y, Ji Y, Li J et al (2018) Sequential versus simultaneous use of chemotherapy and gonadotropin-releasing hormone agonist (GnRHa) among estrogen receptor (ER)-positive premenopausal breast cancer patients: effects on ovarian function, disease-free survival, and overall survival. Breast Cancer Res Treat 168:679–686. CrossRefPubMedGoogle Scholar
  2. 2.
    Regan MM, Walley BA, Francis PA et al (2017) Concurrent and sequential initiation of ovarian function suppression with chemotherapy in premenopausal women with endocrine-responsive early breast cancer: an exploratory analysis of TEXT and SOFT. Ann Oncol 28:2225–2232. CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Lambertini M, Moore HCF, Leonard RCF et al (2018) Gonadotropin-releasing hormone agonists during chemotherapy for preservation of ovarian function and fertility in premenopausal patients with early breast cancer: a systematic review and meta-analysis of individual patient-level data. J Clin Oncol. PubMedCrossRefGoogle Scholar
  4. 4.
    Oktay K, Harvey BE, Partridge AH et al (2018) Fertility preservation in patients with cancer: ASCO clinical practice guideline update. J Clin Oncol. PubMedCrossRefGoogle Scholar
  5. 5.
    Paluch-Shimon S, Pagani O, Partridge AH et al (2017) ESO-ESMO 3rd international consensus guidelines for breast cancer in young women (BCY3). Breast 35:203–217. CrossRefPubMedGoogle Scholar
  6. 6.
    Lambertini M, Cinquini M, Moschetti I et al (2017) Temporary ovarian suppression during chemotherapy to preserve ovarian function and fertility in breast cancer patients: A GRADE approach for evidence evaluation and recommendations by the Italian Association of Medical Oncology. Eur J Cancer 71:25–33. CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Medical Oncology, Institut Jules BordetUniversité Libre de Bruxelles (U.L.B.)BrusselsBelgium
  2. 2.Department of Medical Oncology, Oncologia Medica 2Ospedale Policlinico San Martino, University of GenovaGenovaItaly
  3. 3.Breast Cancer Translational Research Laboratory, Institute Jules BordetUniversité Libre de Bruxelles (U.L.B.)BrusselsBelgium

Personalised recommendations