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Journal of Peking University (Health Sciences) ›› 2025, Vol. 57 ›› Issue (2): 291-297. doi: 10.19723/j.issn.1671-167X.2025.02.011

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Impact of concurrent use of goserelin on the efficacy of neoadjuvant chemotherapy in young breast cancer patients

Miaoyu LIU1, Siyuan WANG1, Lin PEI2, Shu WANG1,*()   

  1. 1. Breast Center, Peking University People's Hospital, Beijing 100044, China
    2. Clinical Laboratory, Peking University People's Hospital, Beijing 100044, China
  • Received:2021-08-29 Online:2025-04-18 Published:2025-04-12
  • Contact: Shu WANG E-mail:wangshu@pkuph.edu.cn

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Abstract:

Objective: To explore the effect of concurrent administration of goserelin for ovarian function protection on the pathological complete response (pCR) rate and objective response rate (ORR) of neoadjuvant chemotherapy (NAC) in young breast cancer patients. Methods: The study enrolled breast cancer patients aged 18-45 with clinical stages ⅡA~ⅢC from January 2016 to May 2020. According to patients' willingness, they were divided into two groups: Those who chose to receive goserelin to protect ovarian function during NAC (goserelin group) and those who did not (chemotherapy group). The pCR rate and ORR were compared between the two groups, and subgroup analysis was conducted for patients with different molecular subtypes. Results: A total of 93 patients were included in this study (31 in the goserelin group and 62 in the chemotherapy group). After propensity score weighting (PSW) adjustment, baseline data such as age, preoperative clinical stage, postoperative pathological stage, pa-thological type, hormone receptor status, human epidermal growth factor receptor 2 (HER2) and Ki-67 expression, molecular subtypes, and chemotherapy regimens were well-matched between the two groups. There was no significant difference in the pCR rate between the goserelin group and the chemotherapy group, with rates of 29.0% and 25.8%, respectively (P=0.741). Similarly, there was no significant difference in ORR between the two groups (90.3% vs. 87.1%, P=0.746). Subgroup analysis revealed that among the patients with hormone receptor-positive tumors, there were no significant differences in pCR rate (6.3% vs. 7.7%, P=0.852) or ORR (87.5% vs. 82.1%, P=0.839) between the goserelin and chemotherapy groups. Among the patients with hormone receptor-negative tumors, there were also no significant differences in pCR rate (53.3% vs. 56.5%, P=0.847) or ORR (93.3% vs. 95.7%, P=0.975) between the two groups. One year after the completion of chemotherapy, the incidence of chemotherapy-induced amenorrhea (CIA) was significantly lower in the goserelin group compared with the chemotherapy group (9.5% vs. 33.3%, P=0.036). Conclusion: For young breast cancer patients with clinical stages of ⅡA~ⅢC, there was no statistical difference in pCR rate and ORR whether or not using goserelin during NAC. However, it is still necessary to expand the sample size and carry out a longer follow-up to evaluate the effect of goserelin on the long-term survival of young patients.

Key words: Breast cancer, young, Neoadjuvant chemotherapy, Goserelin

CLC Number: 

  • R737.9

Table 1

Baseline characteristics of patients in the goserelin group and chemotherapy group"

Items Goserelin group
(n=31)		 Chemotherapy group
(n =62)		 P value
Age/years 0.668
  ≤35 16 29
  ＞35 15 33
Clinical tumor stage 1.000
  cT1 6 11
  cT2 22 44
  cT3-4 3 7
Clinical node stage 0.100
  cN0 7 4
  cN1 14 35
  cN2-3 10 23
Clinical stage 0.650
  Ⅱ 21 38
  Ⅲ 10 24
Surgery ＜0.010
  Breast conserving surgery 8 3
  Total mastectomy 23 59
Pathological tumor stage 1.000
  pT0 13 26
  pT1 14 29
  pT2 4 7
  pT3 0 0
Pathological node stage 0.923
  pN0 15 33
  pN1 10 18
  pN2 3 7
  pN3 3 4
Pathological stage 0.384
  0 5 16
  Ⅰ 10 11
  Ⅱ 10 24
  Ⅲ 6 11
Hormone receptors 1.000
  ER+ and/or PR+ 17 35
  ER- and PR- 14 27
HER2 0.655
  Positive 11 26
  Negative 20 36
Ki-67 0.105
  ≥20% 22 53
  ＜20% 9 9
Subtype 0.312
  Luminal A 6 5
  Luminal B 10 34
HER2 over expression 5 11
  Triple negative 10 12
Targeted therapya 0.123
  No 22 41
  Single target therapy 7 8
  Double target therapy 2 13
Chemotherapy 0.494
  AT/A-T(6-8 cycles) 22 39
  Others(6 cycles) 9 23

Table 2

Comparison of pCR rate in different types between chemotherapy groups and goserelin groups"

Items Luminal A Luminal B HER2 over expression Triple negative
Chemotherapy group 0%(0/5) 8.8%(3/34) 81.8%(9/11) 33.3%(4/12)
Goserelin group 0%(0/6) 10.0%(1/10) 60.0%(3/5) 50.0%(5/10)
P value 0.87 0.35 0.43

Table 3

Comparison of ORR in different types between chemotherapy group and goserelin groups"

Luminal A Luminal B HER2 over expression Triple negative
Chemotherapy group 100.0%(5/5) 79.4%(27/34) 100.0%(11/11) 91.7%(11/12)
Goserelin group 100.0%(6/6) 80.0%(8/10) 100.0%(5/5) 90.0%(9/10)
P value 0.91 0.95

Table 4

Single factor Logistic regression analysis of pCR rate after NAC"

Items P value OR 95%CI
Age/years 0.566
  ≥35 1
  ＜35 1.316 0.516-3.360
Clinical tumor stage 0.062
  cT1 1
  cT2 0.319 0.096-1.058
  cT3-4 0.133 0.022-0.814
Clinical node stage 0.737
  cN0 1
  cN1 1.806 0.348-9.358
  cN2 or cN3 1.957 0.357-10.737
Clinical stage 0.912
  Ⅱ 1
  Ⅲ 1.056 0.404-2.761
Hormone receptors 0
  ER- and PR- 1
  ER+ and/or PR+ 0.071 0.021-0.234
HER2 0.056
  Negative 1
  Positive 2.525 0.977-6.523
Ki-67 0.034
  ＜20% 1
  ≥20% 9.388 1.186-74.289
Chemotherapy 0.974
  AT/A-T(6-8 cycles) 1
  Others(6 cycles) 0.984 0.369-2.267
Group 0.616
  Chemotherapy 1
  Goserelin 1.282 0.486-3.379

Table 5

Multivariate Logistic regression analysis of pCR rate after NAC"

Items P value OR 95%CI
Clinical tumor stage 0.008
  cT1 1
  cT2 0.031 0.003-0.355
  cT3-4 0.140 0.001-0.229
Hormone receptors 0.001
  ER- and PR- 1
  ER+ and/or PR+ 0.024 0.003-0.205
HER2 0.027
  Negative 1
  Positive 4.432 1.181-16.633
Ki-67 0.095
  ＜20% 1
  ≥20% 7.344 0.706-76.371
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