With the extensive media coverage of a study indicating that injections with the luteinizing hormone–releasing hormone (LHRH) agonist goserelin (Zoladex) may offer a new option for preserving fertility among women treated for breast cancer, physicians can expect questions from interested patients. Presented at the 2014 ASCO Annual Meeting in Chicago, the study found that goserelin can reduce the risk of ovarian failure and increase the possibility of successful pregnancies among premenopausal women being treated with chemotherapy for early-stage breast cancer.

Patients who have read or heard about the study need to know that this new option “is really only for newly diagnosed patients,” the study’s lead author, Halle Moore, MD, told The ASCO Post. Dr. Moore is a Staff Physician and Chair of the Survivorship Program at the Cleveland Clinic. The first injection of goserelin needs to be administered at least 1 week before chemotherapy starts, with additional doses administered once a month over the duration of the chemotherapy regimen.

Addressing Survivorship

“This is not for people who are interested in fertility years after their treatment. This is really addressing survivorship at the time of initial diagnosis, which I think is something we need to be doing increasingly,” Dr. Moore remarked.

Goserelin is approved by the Food and Drug Administration for advanced breast cancer, but not for use in women with early-stage breast cancer. Because preserving fertility among women with early-stage breast cancer is not an approved use, patients considering this option should be advised to check their insurance coverage.

The study included only women with estrogen receptor/progesterone receptor–negative breast cancer. Dr. Moore cautioned that more research is needed to understand any role goserelin may have in preserving fertility among women treated for other types of cancer. ■