J Breast Cancer.  2015 Dec;18(4):365-370. 10.4048/jbc.2015.18.4.365.

Concurrent Gonadotropin-Releasing Hormone Agonist Administration with Chemotherapy Improves Neoadjuvant Chemotherapy Responses in Young Premenopausal Breast Cancer Patients

• Kim HJ
• Yoon TI
• Chae HD
• Kim JE
• Chae EY
• Yu JH
• Sohn G
• Ko BS
• Lee JW
• Son BH
• Ahn SH

• KMID: 2176285
• DOI: http://doi.org/10.4048/jbc.2015.18.4.365

Abstract

PURPOSE
This study aimed to determine the oncologic efficacy of gonadotropin-releasing hormone (GnRH) agonist treatment concurrent with chemotherapy in a neoadjuvant setting.
METHODS
A retrospective analysis was performed on 332 cases of invasive breast cancer in patients who were <40 years old at diagnosis and received GnRH agonists concurrent with neoadjuvant chemotherapy (GnRH agonist group) or neoadjuvant chemotherapy alone (neochemotherapy-alone group) from December 2010 to September 2014. Pathologic complete response rates (pCR) and Ki-67 changes were evaluated between the two groups.
RESULTS
Median age was 32+/-3.9 and 36+/-3.0 years in the GnRH agonist group and neochemotherapy-alone group, respectively (p<0.001). After adjustment for tumor size, grade, lymph node metastasis, hormone receptor (HR) status, and chemotherapy regimen, the GnRH agonist group exhibited a higher pCR rate with an odds ratio (OR) of 2.98 (95% confidence interval [CI], 1.37-6.34) and a greater decrease in Ki-67 expression after treatment (p=0.05) than the neochemotherapy-alone group. For HR-negative tumors, the GnRH agonist group showed a higher pCR rate (multivariate OR, 3.50; 95% CI, 1.37-8.95) and a greater decrease in Ki-67 expression (p=0.047). For HR-positive breast cancer, the pCR rate, change in Ki-67 index, and clinical response were higher, and preoperative endocrine prognostic index scores were lower, in the GnRH agonist group, but these did not reach statistical significance.
CONCLUSION
Concurrent administration of GnRH agonists during neoadjuvant chemotherapy improved pCR rates and suppressed Ki-67 expression, especially in HR-negative tumors.

Keyword

Breast neoplasms; Drug therapy; Gonadotropin-releasing hormone agonist

MeSH Terms

Breast Neoplasms*
Breast*
Diagnosis
Drug Therapy*
Gonadotropin-Releasing Hormone*
Humans
Lymph Nodes
Neoplasm Metastasis
Odds Ratio
Polymerase Chain Reaction
Retrospective Studies
Gonadotropin-Releasing Hormone

Figure

• 

  Figure 1 Multivariate odds ratio of pathologic complete response after neoadjuvant chemotherapy between two treatment groups. GnRH=gonadotropin-releasing hormone; CI=confidence interval.

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