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. 2015 Dec;18(4):365-70.
doi: 10.4048/jbc.2015.18.4.365. Epub 2015 Dec 23.

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

Hee Jeong Kim  1 , Tae-In Yoon  1 , Hee Dong Chae  2 , Jeong Eun Kim  3 , Eun Young Chae  4 , Jong Han Yu  1 , Guiyun Sohn  1 , Beom Seok Ko  1 , Jong Won Lee  1 , Byung Ho Son  1 , Sei Hyun Ahn  1
Affiliations

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

Hee Jeong Kim et al. J Breast Cancer. 2015 Dec.

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.

Keywords: Breast neoplasms; Drug therapy; Gonadotropin-releasing hormone agonist.

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Conflict of interest statement

CONFLICT OF INTEREST: The authors declare that they have no competing interests.

Figures

Figure 1
Figure 1. Multivariate odds ratio of pathologic complete response after neoadjuvant chemotherapy between two treatment groups.
GnRH=gonadotropin-releasing hormone; CI=confidence interval.
See this image and copyright information in PMC

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