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Key Paper Evaluation

Use of LHRH-agonists as adjuvant therapy for breast cancer

Evaluation of: LHRH-agonists in Early Breast Cancer Overview group. Use of luteinising-hormone-releasing hormone agonistsas adjuvant treatment in premenopausal patients with hormone-receptor-positive breast cancer: a meta-analysis of individual patient data from randomised adjuvant trials. Lancet 2007;369(9574):1711-23

Pages 1065-1071 | Published online: 12 Jul 2008
 

Abstract

Individual data was collected for 11,906 women in 16 randomised trials evaluating a luteinising-hormone-releasing hormone (LHRH) agonist either alone, as an addition to tamoxifen or chemotherapy or in place of chemotherapy. When used alone these agents led to a large (28%) relative decrease in recurrence, which was not significant (p = 0.08) due to the small number of patients randomised. Addition of LHRH-agonist to tamoxifen, chemotherapy or both, reduced recurence by 13% (p = 0.02), and when used alone these agents showed similar efficacy to chemotherapy. The largest effect after chemotherapy was seen in women aged ≤ 40 years. Most of the chemotherapy was CMF-based, so comparisons with more modern chemotherapy would be useful. In addition, the optimum duration of treatment is unknown.

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