Comparison of goserelin and leuprorelin for ovarian protection during chemotherapy in young patients with breast cancer

Breast Cancer Res Treat. 2023 Apr;198(2):231-237. doi: 10.1007/s10549-023-06877-4. Epub 2023 Feb 13.

Abstract

Purpose: Although different gonadotropin-releasing hormone (GnRH) agonists may have different effects, their effect of ovarian protection during chemotherapy for breast cancer has not been compared. This study aimed to compare the effects of goserelin and leuprorelin for ovarian protection during chemotherapy in young patients with breast cancer.

Methods: This prospective study analyzed 193 patients with breast cancer aged ≤ 40 years who had regular menstruation and serum anti-Müllerian hormone (AMH) levels ≥ 1 ng/mL before treatment. Patients received either goserelin or leuprorelin for ovarian protection during doxorubicin/cyclophosphamide-based chemotherapy. Resumption of menstruation and changes in serum levels of AMH were compared between the two groups at 12 months after completion of chemotherapy.

Results: The mean age and the pretreatment serum AMH level were 33.2 years and 4.4 ng/mL in goserelin group and 34.2 years and 4.0 ng/mL in leuprorelin group. The proportion of patients who resumed menstruation was not different between the goserelin (94.4%) and leuprorelin (95.3%) groups at 12 months after chemotherapy completion. Serum AMH levels decreased significantly in both the goserelin (from 4.4 to 1.2 ng/mL) and leuprorelin (from 4.0 to 1.2 ng/mL) groups, with no statistical significance. In addition, no difference was found in the proportion of patients with serum AMH levels ≥ 1 ng/mL between the goserelin (49.5%) and leuprorelin (44.2%) groups at 12 months after chemotherapy.

Conclusion: Goserelin and leuprorelin were comparable in terms of ovarian protection during doxorubicin/cyclophosphamide-based chemotherapy in young patients with breast cancer.

Keywords: Breast cancer; Chemotherapy; GnRH agonist; Goserelin; Leuprorelin; Ovarian protection.

MeSH terms

  • Breast Neoplasms*
  • Cyclophosphamide / adverse effects
  • Doxorubicin / adverse effects
  • Female
  • Goserelin / adverse effects
  • Humans
  • Leuprolide / therapeutic use
  • Peptide Hormones*
  • Prospective Studies

Substances

  • Goserelin
  • Leuprolide
  • Cyclophosphamide
  • Doxorubicin
  • Peptide Hormones