Efficacy and Feasibility of Long-Acting Every Three Months Goserelin for Premenopausal Breast Cancer Patients during the COVID Pandemic

Background: Monthly Goserelin has demonstrated safety and efficacy in treating pre-menopausal breast cancer patients. This study aims to evaluate the safety and efficacy of every 3-monthly goserelin 10.8 mg.
Methods: Cohort A: Patients received 10.8 mg of goserelin every 12 weeks. Cohort B: Retrospective review of patients’ files who received monthly Goserelin.
Results: 41 patients (cohort A) and 42 patients (cohort B) were included, and the median ages were 37y and 35y respectively. Cohort A vs B: stage II (21.9% vs 21.4%), stage III (48.8% vs 52.4%) and stage IV (29.3% vs 26.2%). Luminal A (34.1% vs 30.9%), B1 (56.1% vs 57.1%) and B2 (9.8 vs 11.9%). The mean baseline E2 level in cohort A was 254.9 pg/dl. The median follow-up duration was 21 months.
The mean E2 levels in cohort A were 15.4 ng/dl, 10.8 ng/dl, and 9.6 ng/dl at weeks 12, 24, and 36 respectively. All patients developed amenorrhea. For non-metastatic patients the disease-free survival (DFS) was 86.2% for cohort A (n=29) and 87.1% for cohort B (n=31) without statistically significant difference (p=0.71). Metastatic patients’ progression-free survival (PFS) was 66.7% for cohort A (n= 12) and 63.6% for cohort B (n= 11) without statistically significant difference (p=0.88). All patients are alive, and no serious adverse events were observed in both group, hot flushes (65.8 % vs 66.7%), headache (36.6 % vs 40.5%), arthralgia (26.8% vs 28.5%), and hyperhidrosis (7.3 %vs 7.1%).
Conclusion: 3-monthly goserelin is safe and effective with less frequent hospital visits that reduce exposure to infection, especially during the COVID pandemic.