A new treatment for endometrial cancer with gonadotrophin releasing-hormone analogue

Article Abstract:

Recurrent endometrial cancer (cancer of the uterine lining) that has been treated with radiation and/or surgery has a poor prognosis. In these cases, the most effective approach has been therapy with progestogens (female hormones). When these drugs are used, between 30 percent and 40 percent of the patients with well-differentiated tumors respond for a median of 24 months. Analogues of gonadotrophin releasing-hormone (GnRH), the hormone that stimulates the ovaries to produce their hormones, are of proven effectiveness in treating prostate cancer, premenopausal breast cancer, and, to some extent, ovarian cancer. These drugs were tested on 17 patients (median age, 55) with recurrent endometrial adenocarcinoma. The subjects received one monthly injection consisting of leuprorelin (16 patients) or goserelin (one patient); and two patients also received tamoxifen. Their blood levels of gonadotrophins, sex hormones, and cancer antigen CA 125 were measured at regular intervals. Results showed a median disease-free interval of 18 months. Disease recurred at a median of two sites; in only two cases was the relapse confined to the pelvis. Patients' blood levels of gonadotrophins decreased within one month of treatment onset and were suppressed throughout treatment. Sex hormone levels did not change. Six patients responded to the drugs, with one complete and five partial remissions. Five were still in remission at the time the article was written, with one lost to follow-up because of emigration. Nine patients died within six months of starting treatment and two had stable disease. GnRH analogues appear to be effective and nontoxic in treating recurrent endometrial cancer and their use warrants further investigation. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Endometrial cancer, Gonadotropin releasing hormone, Gonadorelin

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The combination of a depot gonadotrophin releasing hormone agonist and cyclical hormone replacement therapy for dysfunctional uterine bleeding

Article Abstract:

The effectiveness was investigated of the use of combination of hormones for treating dysfunctional uterine bleeding (DUB), a common problem. The hormones used were goserelin (Zoladex), an agonist of gonadotrophin releasing hormone (GnRH), the hormone that stimulates the pituitary to release gonadotrophins, which then stimulate the ovaries: and hormone replacement therapy (HRT; estradiol and norgestrol) of the type commonly prescribed for postmenopausal women. Twenty women with regular, heavy menstrual bleeding underwent treatment with goserelin and HRT during three cycles. Menstrual blood loss was measured before the study began, during each cycle, and 12 weeks after the last goserelin injection. Results showed reduced menstrual loss for 19 women in the first treatment cycle; for all women in the second cycle; and for 19 in the last cycle. Menstrual loss increased in one woman during treatment. The median length of menstruation decreased significantly during treatment, and fewer women experienced pain, premenstrual symptoms, flooding, and clot passage. Hot flushes occurred in 17 cases, and in two patients they were considered severe. Overall, satisfaction was reported by 18 patients. Although this combination of GnRH agonist and HRT was effective in treating DUB, its high cost suggests that it be recommended only to women with demonstrably heavy menstrual loss. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Hormone therapy, Uterine bleeding, Uterine hemorrhage

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