天美传媒

Goserelin; Breast Cancer; Hormone Receptor-Positive; Premenopausal; Adjuvant Endocrine Therapy; Ovarian Function Suppression; Prostate Cancer; Endometrial Polyps; Leuprolide; Neoadjuvant Chemotherapy

Introduction

Recent research has extensively explored the therapeutic applications of goserelin acetate across various medical conditions, primarily focusing on hormone-sensitive cancers and gynecological disorders. One significant area of study involves its use in premenopausal patients diagnosed with hormone receptor-positive early breast cancer. Studies show that combining goserelin with adjuvant endocrine therapy considerably improves invasive disease-free survival and distant relapse-free survival compared to endocrine therapy alone, presenting a valuable and clinically supported treatment strategy for this specific patient demographic. The manageable safety profile further bolsters its potential for widespread clinical application [1].

This meta-analysis looked at the comparative efficacy and safety of leuprolide acetate and goserelin acetate for procedures like endometrial ablation and myomectomy. This review determined that both agents are effective and safe in their capacity to reduce uterine volume and alleviate anemia symptoms prior to surgery. The insights gained from this comparative analysis underscore their similar clinical utility in a range of gynecological procedures [2].

Furthermore, a real-world study evaluated goserelin acetate paired with exemestane in premenopausal patients facing hormone receptor-positive breast cancer. The results from this study reveal that this combination therapy contributes to favorable disease-free survival and overall survival rates, all while maintaining a manageable side effect profile. This strongly reaffirms its established role in the adjuvant treatment landscape for this particular patient group [3].

The optimal duration of adjuvant ovarian function suppression using goserelin acetate has also been a subject of keen interest, particularly for premenopausal patients with hormone receptor-positive early breast cancer. Research has compared regimens of 2 years versus 5 years, offering crucial insights into whether a longer duration of goserelin administration translates into additional benefits for disease outcomes and recurrence prevention for these patients [4].

Expanding on the comparative studies, a meta-analysis focused on goserelin and leuprolide for ovarian protection in young breast cancer patients undergoing adjuvant chemotherapy. The findings indicated that both agents are equally effective in preserving ovarian function, thereby reducing the risk of premature ovarian failure and subsequently improving fertility outcomes, with no significant differences observed in their protective efficacy or safety profiles [5].

Beyond breast cancer and gynecological applications, goserelin acetate plays a vital role in prostate cancer management. A detailed review outlined its evolving role, from initial use as a monotherapy for castration to its current integration into combination regimens. This highlights goserelin's consistent efficacy in achieving androgen deprivation and firmly places it within modern treatment strategies across various stages of prostate cancer [6].

Another systematic review and meta-analysis specifically investigated goserelin acetate as a promising treatment for endometrial polyps. The outcomes suggest that goserelin can notably reduce both the size and number of endometrial polyps, thus providing a non-surgical therapeutic alternative for patients, especially those prioritizing fertility preservation or wishing to avoid invasive surgical procedures [7].

Further real-world evidence reinforces the benefits of goserelin therapy. One study demonstrated that adjuvant goserelin significantly improves disease-free survival in premenopausal patients with hormone receptor-positive early breast cancer. These compelling results emphasize the profound importance of ovarian function suppression as an integral part of a comprehensive adjuvant treatment plan, ultimately leading to superior long-term outcomes for these patients [8].

Complementing this, a long-term follow-up study specifically examined the impact of a 2-year adjuvant goserelin regimen in premenopausal patients with hormone receptor-positive early breast cancer. The findings consistently reinforced the sustained benefits of this particular treatment duration in effectively preventing recurrence and enhancing overall survival, solidifying its well-established role within the adjuvant setting for a substantial patient population [9].

Finally, a systematic review and meta-analysis evaluated the efficacy and safety of goserelin when combined with neoadjuvant chemotherapy for patients presenting with locally advanced breast cancer. The consensus from this review indicated that the addition of goserelin to neoadjuvant chemotherapy leads to improved pathological complete response rates and better overall survival. This strongly suggests a considerable benefit in downstaging tumors and significantly enhancing long-term patient prognoses [10].

Description

Goserelin acetate has emerged as a cornerstone in the treatment of various hormone-sensitive conditions, particularly in oncology and gynecology. In the realm of breast cancer, its efficacy is well-documented, especially for premenopausal patients with hormone receptor-positive early breast cancer. Combining goserelin with adjuvant endocrine therapy has shown a remarkable ability to improve invasive disease-free survival and distant relapse-free survival compared to endocrine therapy alone. This approach offers a significant advantage, providing patients with a valuable treatment strategy that also maintains a manageable safety profile [1]. Further real-world evidence supports this, indicating that adjuvant goserelin therapy markedly improves disease-free survival for these patients, underscoring the critical role of ovarian function suppression in comprehensive adjuvant treatment plans, leading to better long-term outcomes [8]. Additionally, the combination of goserelin acetate plus exemestane has been assessed in similar patient populations, demonstrating favorable disease-free survival and overall survival rates with an acceptable side effect profile, solidifying its importance in adjuvant care [3].

For young breast cancer patients undergoing adjuvant chemotherapy, ovarian protection is a crucial concern. Goserelin, alongside leuprolide, has been evaluated in meta-analyses for its role in preserving ovarian function. These studies highlight that both agents are effective in reducing the risk of premature ovarian failure and improving fertility outcomes, with no significant differences found in their protective efficacy or safety profiles [5]. Moreover, the strategic use of goserelin is not limited to adjuvant settings. When combined with neoadjuvant chemotherapy for patients with locally advanced breast cancer, goserelin has been shown to improve pathological complete response rates and overall survival. This suggests a notable benefit in downstaging tumors and enhancing long-term prognoses, indicating its versatility across different stages of breast cancer treatment [10].

The duration of ovarian function suppression with goserelin acetate is another area of active investigation. For premenopausal patients with hormone receptor-positive early breast cancer, studies have compared 2-year versus 5-year durations of adjuvant goserelin. The aim is to determine if a longer course provides additional benefits in terms of disease outcomes and recurrence prevention [4]. Long-term follow-up studies have, for instance, reinforced the sustained benefits of a 2-year adjuvant goserelin regimen in preventing recurrence and improving survival, solidifying its established role in the adjuvant setting for a significant patient population [9]. These studies help clinicians tailor treatment plans to maximize efficacy while managing potential side effects.

Beyond breast cancer, goserelin acetate also holds relevance in other clinical areas. Its role in prostate cancer management has evolved significantly. Initially used as a monotherapy for castration, goserelin is now often incorporated into combination regimens. Its consistent efficacy in achieving androgen deprivation is a key factor, making it an important component of modern treatment strategies across various stages of prostate cancer [6]. In gynecology, comparative studies have looked at goserelin acetate alongside leuprolide acetate for procedures such as endometrial ablation and myomectomy. These analyses show both agents are effective and safe in reducing uterine volume and improving anemia symptoms pre-surgery, highlighting their similar clinical utility in these gynecological interventions [2].

Furthermore, goserelin acetate is being explored for conditions like endometrial polyps. A systematic review and meta-analysis indicated that goserelin can significantly reduce the size and number of endometrial polyps. This offers a valuable non-surgical therapeutic option, particularly appealing for patients who are seeking fertility preservation or wish to avoid invasive procedures [7]. The broad spectrum of goserelin's applications, from critical cancer treatments to managing benign gynecological conditions, showcases its versatility and importance in modern medicine, continually supported by robust clinical research that refines its optimal use and expands its therapeutic reach.

Conclusion

This collection of studies highlights the diverse and significant clinical applications of goserelin acetate. For premenopausal patients with hormone receptor-positive early breast cancer, combining goserelin with adjuvant endocrine therapy consistently improves disease-free survival and reduces relapse rates, reinforcing its role in long-term outcomes. The efficacy extends to combinations with exemestane and to neoadjuvant chemotherapy for locally advanced breast cancer, where it enhances pathological complete response and overall survival. Research also addresses the optimal duration of goserelin therapy, with 2-year regimens showing sustained benefits. Beyond breast cancer, goserelin demonstrates comparable effectiveness to leuprolide in ovarian protection during chemotherapy for younger patients, helping preserve fertility. It also proves useful in managing gynecological conditions, effectively reducing uterine volume prior to surgery for endometrial ablation and myomectomy, and showing potential as a non-surgical treatment for endometrial polyps. Its established role in prostate cancer management, from monotherapy to combination regimens for androgen deprivation, further illustrates its broad impact. Collectively, the data confirm goserelin as a versatile and effective agent, improving survival, preventing recurrence, and offering therapeutic benefits across various hormone-sensitive medical conditions with a manageable safety profile.

References

• Hua L, Teng S, Tengfei Z (2023) .Front Endocrinol (Lausanne) 14:1195669.

, ,

• Jia Z, Yu W, Hua X (2022) .Gynecol Obstet Invest 87:440-449.

, ,

• Peng Z, Ruoqing Z, Shu J (2021) .Sci Rep 11:15309.

, ,

• Yu C, Xiao H, Xiaoli L (2023) .Ann Transl Med 11:366.

, ,

• Jie T, Weijun D, Yong W (2022) .Medicine (Baltimore) 101:e32402.

, ,

• Audrey G, Franck B, Stephane C (2020) .Expert Opin Pharmacother 21:1019-1029.

, ,

• Yuxia C, Xiaojing L, Wei W (2023) .Gynecol Obstet Invest 88:203-211.

, ,

• Xi X, Qili Z, Meng Z (2022) .Oncol Res Treat 45:36-42.

, ,

• Ke WL, Byung SK, Jun WL (2021) .Clin Breast Cancer 21:440-449.

, ,

• Huimin R, Ting Z, Jing H (2024) .Cancer Med 13:e17109.

, ,