An intervention to improve quality of life for women

An intervention to improve quality of life for women

How can we help women undergoing toxic chemotherapy avoid early menopause, infertility and other potential consequences of ovarian failure?

That was a question uppermost in Dr Janine Lombard’s mind when she joined an international research team to investigate the use of a drug that temporarily puts ovaries to sleep.

The Medical Oncology Staff Specialist was the lead local investigator for the Prevention of Early Menopause study, known as POEMS. It tested the use of the drug Goserelin, which suppresses hormone production.

Worldwide, 257 premenopausal women took part, five of them from Calvary Mater Newcastle. Each was undergoing chemotherapy for a specific type of early breast cancer. Half of the women received the drug while the remainder received chemotherapy only. The phase 3 randomised study compared rates of ovarian failure at two years, the rate of ovarian dysfunction, and pregnancy outcomes.

Early menopause, infertility and osteoporosis are all signs of ovarian failure, a potentially devastating effect of toxic chemotherapy.

“There is good evidence from POEMS that premature menopause and future pregnancy is improved by using Goserelin during chemotherapy,” Dr Lombard said.

“This very simple intervention can significantly improve quality of life for women with early breast cancer.”

“We found continued evidence that patients randomly assigned to receive Goserelin and chemotherapy were not only more likely to avoid premature menopause, but were also more likely to become pregnant without adverse effect on disease-related outcomes.”

Results from the study, published in the New England Journal of Medicine, show that women given the drug before and during chemotherapy had reduced rates of ovarian failure (8 per cent) compared with those who had no additional protection during chemotherapy (22 per cent). Pregnancy rates were also higher.

Good news for women is that Goserelin is now freely available on the PBS and can be used in any tumour type where fertility preservation/prevention of early menopause is regarded as important.

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