SAN FRANCISCOWhile bone mineral density decreases with ovarian
ablation via the leutinizing hormone releasing hormone (LHRH) analog goserelin (Zoladex), the loss is partly
recovered within a year after 2 years of treatment. Also, the loss may be
minimized by the addition of tamoxifen (Nolvadex), according to an analysis of
ZIPP (Zoladex in Premenopausal Patients) trial data presented at the 37th
Annual Meeting of the American Society of Clinical Oncology (ASCO abstract 96).
Ovarian ablation improves survival for premenopausal women with early breast
cancer, said A. Sverrisdóttir, MD, Huddinge University Hospital, Stockholm,
Sweden. The benefits of treatment with LHRH analogs have been comparable to the
benefits of chemotherapy. Concerns remain, however, about inducing a premature
menopause because of the known increased risk of bone mineral density loss with
While it is known that tamoxifen has estrogen agonist effects, the potential
adverse effects of LHRH analog treatment on bone are unknown, Dr.
Sverrisdóttir said. Furthermore, the net effect of the combination of ovarian
ablation and tamoxifen in premenopausal women is unknown.
In the ZIPP trial results presented at ASCO 2000, recurrence-free survival
benefits for adjuvant therapy with goserelin were highly significant (P = .001)
in premenopausal women with node-negative breast cancer who did not receive
Bone Mineral Density Data
For the current analysis, bone mineral density data from 73 Stockholm
participants in the trial were evaluated. The patients received no adjuvant
therapy (n = 22), tamoxifen (40 mg/d for 2 years, n = 19), goserelin alone (3.6
mg every 28 days for 2 years, n = 17), or tamoxifen plus goserelin (n = 15).