A Pilot Study of Predictive Markers of Chemotherapy-Related Amenorrhea Among Premenopausal Women with Early Stage Breast Cancer

Anders, Carey K.; Marcom, P. Kelly; Peterson, Bercedis L.; Gu, Lin; Unruhe, Sue; Welch, Renee; Lyons, Peggy; Kimmick, Gretchen; Shaw, Heather S.; Snyder, Stacey; Antenos, Monica; Woodruff, Teresa K.; Blackwell, Kimberly

doi:10.1080/07357900701829777

Cited by 105 publications

(100 citation statements)

References 20 publications

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“…In large casecontrol studies, BC survivors who underwent CT had lower AMH serum levels than age-matched controls [45,46]. In the majority of studies, high pretreatment AMH levels were associated with higher post-treatment levels [37,41,44]. Similarly, pre-CT AMH was lower among women showing CRA at 1-2 years [38] and at later time points during the follow-up period [50].…”

Section: Discussionmentioning

confidence: 99%

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Predicting Ovarian Activity in Women Affected by Early Breast Cancer: A Meta-Analysis-Based Nomogram

Barnabei¹,

Strigari

Marchetti

et al. 2015

The Oncologist

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Background. The assessment of ovarian reserve in premenopausal women requiring anticancer gonadotoxic therapy can help clinicians address some challenging issues, including the probability of future pregnancies after the end of treatment. Anti-Müllerian hormone (AMH) and age can reliably estimate ovarian reserve. A limited number of studies have evaluated AMH and age as predictors of residual ovarian reserve following cytotoxic chemotherapy in breast cancer patients. Materials and Methods. To conduct a meta-analysis of published data on this topic, we searched the medical literature using the key MeSH terms "amenorrhea/chemically induced," "ovarian reserve," "anti-Mullerian hormone/blood," and "breast neoplasms/drug therapy." Preferred Reporting Items for Systematic Reviews and Meta-Analyses statements guided the search strategy. U.K. National Health Service guidelines were used in abstracting data and assessing data quality and validity. Area under the receiver operating characteristic curve (ROC/AUC)

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Section: Discussionmentioning

confidence: 99%

“…In BC patients, a rapid decrease in AMH levels following CT is invariably seen [37,[41][42][43][44][45][46]. In the pivotal study by Anderson et al [41], AMH serum levels rapidly and markedly fell after the first cycles of CT and during the treatment, becoming undetectable in many patients.…”

Section: Discussionmentioning

confidence: 99%

Predicting Ovarian Activity in Women Affected by Early Breast Cancer: A Meta-Analysis-Based Nomogram

Barnabei¹,

Strigari

Marchetti

et al. 2015

The Oncologist

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“…FSH, E 2 , inhibin A and B, and AMH levels were prospectively evaluated prechemotherapy, post-chemotherapy, 6 months, and 1 year after the end of chemotherapy. Pre-chemotherapy median inhibin B and AMH values were lower among women experiencing CRA (PZ0.03 and PZ0.02 respectively), thus indicating that these markers might be predictive of CRA among premenopausal women undergoing chemotherapy for breast cancer (Anders et al 2008).…”

Section: Amh Chemo-induced Gonadal Damage and Adjuvant Therapy For mentioning

confidence: 97%

“…Amenorrheic and menstruating women were found to have similar AMH values at baseline and at follow-up. Anders et al (2008) analyzed 44 early-stage breast cancer patients at risk of CRA. FSH, E 2 , inhibin A and B, and AMH levels were prospectively evaluated prechemotherapy, post-chemotherapy, 6 months, and 1 year after the end of chemotherapy.…”

Section: Amh Chemo-induced Gonadal Damage and Adjuvant Therapy For mentioning

confidence: 99%

Anti-Müllerian hormone: determination of ovarian reserve in early breast cancer patients

Bozza¹,

Puglisi²,

Lambertini³

et al. 2013

Endocrine-Related Cancer

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Breast cancer is the most common invasive cancer in women of reproductive age. In young women, chemotherapy may induce amenorrhea: it is still uncertain how to assess menopausal status in these patients despite the importance of its definition for choosing appropriate endocrine treatment. In the development of sensitive biomarkers for fertility and ovarian reserve, anti-Mü llerian hormone (AMH) is considered a promising marker of ovarian reserve. The clearest data regarding a clinical use of AMH are related to the measurement of the ovarian pool in women who undergo IVF: the available data, also in breast cancer patients, seem to suggest that AMH measurement, before gonadotropin administration, can be a useful marker for the prediction of women at risk for poor-response or no response to ovarian stimulation. The utility of AMH as a potential marker of chemotherapy-induced ovarian follicular depletion and an early plasma marker of chemotherapy-induced gonadal damage has been evaluated both in young women after treatment for cancer in childhood and in young survivors of hematological malignancies and solid tumors. Several studies have demonstrated a potential utility of AMH, inhibin, or follicle-stimulating factor as biomarkers predicting infertility risk in breast cancer patients, but the studies conducted so far are not conclusive. Further studies are needed in order to define the regimen-specific action of chemotherapy on AMH levels, the percentage of post-treatment recovery of plasma levels of the hormone, and the relationship between menopausal status and AMH.

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“…Interestingly, in a few studies on a limited cohort of patients who received adjuvant CT for EREBC, prechemotherapy AMH (Anderson et al 2006) or AMH and inhibin-B (Anders et al 2008, Su et al 2010b were significantly lower in women who experienced CIA, a predictive of CIA. These results, however, have not been confirmed in another retrospective study (Yu et al 2010).…”

Section: F Torino Et Al: Menopause and Chemo-induced Amenorrheamentioning

confidence: 99%

Recognizing menopause in women with amenorrhea induced by cytotoxic chemotherapy for endocrine-responsive early breast cancer

Torino¹,

Barnabei²,

Vecchis³

et al. 2012

Endocrine-Related Cancer

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Cytotoxic anticancer treatment may induce amenorrhea or menopause to a variable extent. These side effects may not only impair or impede fertility but also cause sexual dysfunction, bone loss, and menopausal symptoms, with a strikingly negative effect on quality of life in many women. Aromatase inhibitors (AIs) are a recommended adjuvant endocrine treatment option in postmenopausal patients affected by early breast cancer (EBC) but are contraindicated in premenopausal women and in those with residual ovarian function. Women over 40 years of age with chemotherapy-induced amenorrhea (CIA) and routine hormonal levels consistent with menopause may receive an AI as adjuvant endocrine treatment. For these women, the tools available to identify menopause do not appear to be completely reliable. This review focused on the pathophysiology of ovarian toxicity induced by cytotoxic agents and on potentially useful methods to diagnose chemotherapy-induced menopause in patients treated with adjuvant chemotherapy for endocrine-responsive EBC. Moreover, practical approaches are proposed to distinguish true menopausal women, who would benefit from AIs, from those with transient or persistent CIA.

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A Pilot Study of Predictive Markers of Chemotherapy-Related Amenorrhea Among Premenopausal Women with Early Stage Breast Cancer

Abstract: Background-Premenopausal women treated for early stage breast cancer (ESBC) are at risk for chemotherapy-related amenorrhea (CRA). Prospectively-validated, predictive markers of CRA are needed.

Cited by 105 publications

References 20 publications

Predicting Ovarian Activity in Women Affected by Early Breast Cancer: A Meta-Analysis-Based Nomogram

Predicting Ovarian Activity in Women Affected by Early Breast Cancer: A Meta-Analysis-Based Nomogram

Anti-Müllerian hormone: determination of ovarian reserve in early breast cancer patients

Recognizing menopause in women with amenorrhea induced by cytotoxic chemotherapy for endocrine-responsive early breast cancer

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