About 78 per cent of healthy pre-menopausal women would prefer goserelin (Zoladex) therapy to chemotherapy if they were to develop oestrogen-receptor positive (ER+) early breast cancer, according to a new research published in the European Journal of Cancer (EJC).
Women in the study were asked to imagine that they had been diagnosed with early breast cancer and were provided with scenarios describing the administration and side-effects and impact on fertility of treatment with goserelin and treatment with standard chemotherapy (CMF). The women were then asked a series of questions to determine which treatment they would choose and why. Of a total 200 women, aged between 25 and 49 years of age, 78 per cent favoured goserelin, 11 per cent chemotherapy and 11 per cent remained undecided.
The study found that women viewed the side-effect profile of goserelin as more acceptable than standard chemotherapy. Most women questioned would prefer to avoid the side effects associated with chemotherapy, in particular hair loss. Retaining fertility was important for a subgroup of predominantly younger women who have not yet had or not completed their families, according to a release from AstraZeneca.
Professor Lesley Fallowfield, the study author and director of Cancer Research UK's Psychosocial Oncology Group commented: "It is really important that women are given full information by their doctors and specialist nurses about the affect that different treatments may have physically, emotionally and practically before making any decisions about treatment options." He added, "We need to recognise that the side-effects of chemotherapy, especially hair loss, are potentially devastating to young women already coming to terms with a life-changing diagnosis of breast cancer."
Researcher Rhona McGurk, who conducted most of the interviews said," Over a third of women felt that goserelin would be more convenient and less disruptive to normal life than chemotherapy."
Clinical trial data has shown the equivalent efficacy of goserelin therapy compared with CMF regimes. However, despite clinical trial results and treatment guidelines from St Gallen and EUSOMA, pre-menopausal women with hormone-sensitive early breast cancer are rarely offered the choice of goserelin. These findings suggest that pre-menopausal women with hormone-sensitive, early breast cancer should be offered the choice of either adjuvant hormone therapy or adjuvant chemotherapy. Additionally, data from breast cancer patients shows that overall quality of life is significantly better with goserelin than with CMF during the first six months of therapy.
Professor Lesley Fallowfield added, "Despite long-term efficacy and tolerability data to support the use of goserelin in the treatment of premenopausal women with hormone-sensitive, early breast cancer and the different impacts that the treatments have on quality of life, many clinicians still do not even offer women the option of goserelin."
AstraZeneca's Zoladex (goserelin) is indicated in more than 100 countries for use in the hormonal (endocrine) treatment of breast cancer in pre-menopausal women. First licensed for the treatment of breast cancer in premenopausal women in 1990, its indication now covers treatment of both early and advanced stages of the disease in many countries.