Drug may cut menopause after breast cancer chemo

Early menopause is often a side effect for women treated with chemotherapy for breast cancer, but a new study reveals some guarded promise for preventing early menopause breast cancer patients. The results are published in the Journal of the American Medical Association.

While most breast cancer is diagnosed at later ages, about 6% of women learn that they're ill before age 40 - when they are still of childbearing age. Breast cancer treatments that have shown the best results for for disease free survival include chemotherapy, hormonal therapy, or both. For younger women still hoping for children, these treatments can cause devastating short-term or long-term loss of menstrual periods, and loss of fertility. While many women choose to preserve the option of having children by storing eggs before cancer treatment, the process can be costly and difficult.

Italian researchers conducted a phase three study that included 281 women with breast cancer, aged 18 to 45 years and who had not experienced menopause. Patients were randomly selected to be treated with chemotherapy alone or with chemotherapy and triptorelin, a drug, called a GnRH analogue, that prevents the ovaries from releasing eggs. The researchers followed the women for one year after they had finished chemotherapy.

Among the women who had not received triptorelin, the rate of early menopause was 25.9%. Among the women who had received triptorelin, the rate of early menoapuse was 8.9%, which is 17% lower.

An accompanying editorial by Dr. Hope S. Rugo and Dr. Mitchell P. Rosen of the University of California-San Francisco says that trptorelin therapy should not be recommended as a standard treatment and should be approached with caution in women with hormone-sensitive disease. They also stress that women resuming their menstrual cycles does not mean the same thing as women preserving their fertility. They conclude that using assisted reproductive technology – such as storing eggs before chemo, is “the most effective option for fertility preservation.”

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