Impact of Chemotherapy-induced Menopause in Women of Childbearing Age With Non-metastatic Breast Cancer – Preliminary Results From the MENOCOR Study

Passildas, Judith; Collard, Olivier; Savoye, Aude-Marie; Dohou, Joyce; Ginzac, Angeline; Thivat, Émilie; Durando, Xavier; Kwiatkowski, Fabrice; Penault‐Llorca, Frédérique; Abrial, Catherine; Mouret-Reynier, Marie-Ange

doi:10.1016/j.clbc.2018.10.003

Cited by 15 publications

(19 citation statements)

References 42 publications

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“…Indeed, pretreatment AMH levels were predictive for chemotherapy-induced POI in patients who were premenopausal with breast cancer. In the study by Anderson et al ( 89 ), a cutoff pretreatment AMH level of <7.3 pmol/L (1.022 ng/mL) yielded an AUC of 0.77 with a sensitivity of 95% and specificity of 49%, while in the study of Xue et al, an AMH cutoff value of 0.965 ng/mL yielded a slightly higher AUC of 0.84 with a sensitivity of 74% and specificity of 82% ( 90 , 91 ). Likewise, pretreatment AMH levels may predict ovarian recovery, expressed as an AMH level ≥1 ng/mL at 12 months postchemotherapy (adjusted OR 1.659; CI 95%, 1.261-2.182), although the detected value was modest after 2 years follow-up (adjusted OR 1.275; CI 95%, 1.141-1.426) ( 92 ).…”

Section: Assessment Of the For After Cancer Treatmentmentioning

confidence: 97%

Anti-Müllerian Hormone and Ovarian Reserve: Update on Assessing Ovarian Function

Moolhuijsen

Visser

2020

The Journal of Clinical Endocrinology &Amp; Metabolism

330

235

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Context Anti-Müllerian hormone is produced by granulosa cells of small growing follicles in the ovary. Serum AMH levels strongly correlate with the number of growing follicles, and therefore it has received increasing attention as a marker for ovarian reserve. This review summarizes recent findings and limitations in the application of serum AMH in ovarian reserve assessment. Evidence acquisition A PubMed search was conducted to find recent literature on the measurements and use of serum AMH as a marker for ovarian reserve. Evidence synthesis Serum AMH levels are measured to assess the ‘functional ovarian reserve’, a term that is preferred over ‘ovarian reserve’, since AMH levels reflect the pool of growing follicles which potentially can ovulate. Serum AMH levels are used in individualized FSH dosing protocols and may predict the risk of poor response or OHSS, but has limited value in predicting ongoing pregnancy. Serum AMH levels are studied to predict natural or disease-related age of menopause. Studies show that the age-dependent decline rates of AMH vary among women. The generalized implementation of serum AMH measurement has also lead to an increase in diagnostic assays, including automated assays. However, direct comparison of results remains problematic. Conclusion Serum AMH remains the preferred ovarian reserve marker. However, the lack of an international standard for AMH limits comparison between AMH assays. Furthermore, still little is known about endogenous and exogenous factors that influence serum AMH levels, which limits proper interpretation of AMH values in a clinical setting.

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Section: Assessment Of the For After Cancer Treatmentmentioning

confidence: 97%

Anti-Müllerian Hormone and Ovarian Reserve: Update on Assessing Ovarian Function

Moolhuijsen

Visser

2020

The Journal of Clinical Endocrinology &Amp; Metabolism

330

235

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“…Another study, MENOCOR, examines the impact of chemotherapy induced menopause (CIM) on QoL [ 9 ]. Preliminary results from 58 women (age, 18–46 years) show that overall QoL, perhaps not surprisingly, differed significantly for both CIM (n = 41) and non-CIM (n = 17) groups at six months post chemotherapy.…”

Section: Discussionmentioning

confidence: 99%

“…Results showed both outcomes were significantly reduced in patients receiving goserelin, but only in younger patients, aged up to 40 years at randomisation [ 2 ]. Despite these benefits, POI has potential adverse consequences, including decreased quality of life [ 9 ], sexual dysfunction [ 5 , 6 ], and menopausal symptom distress [ 10 ] and in the longer term women are at increased risk of developing osteoporosis, and cardiovascular disease [ 11 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

The affect of goserelin on the QoL of women having chemotherapy for EBC: Results from the OPTION trial

Leonard

Yellowlees²,

Mansi

et al. 2020

The Breast

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Background The OPTION trial results showed that premenopausal women with early stage breast cancer (EBC) receiving chemotherapy benefited from ovarian function protection with goserelin. The impact of treatments on patient reported Quality of Life (QoL) were also examined. Patients and methods 227 pre-menopausal women with EBC, were randomly assigned to chemotherapy±goserelin (C±G); 132 (58%) were ER-ve. Patients were stratified by age (≤40 years and >40 years). QoL was assessed with the Functional Assessment of Cancer Therapy – Breast, and Endocrine Symptom checklist at baseline (pre-treatment), 3, 6, 12, 18 and 24 months, then annually to 5 years. Treatment Outcome Index (TOI) score was the primary outcome. Results 213 patients were available for QoL analysis. There was a significant decrease in TOI scores for both treatment groups at 3 and 6 months that returned to pre-treatment levels at 12 months, then continued to increase reflecting improved QoL. By 3 months there was a significant difference from baseline in both groups for menopausal symptoms, and between groups in the proportion experiencing hot flushes at any time. The C + G group experienced higher levels of vasomotor symptoms generally during the treatment phase; by 24 months, the short-term negative effect of goserelin was reversed, with hot flushes twice as frequent in the chemotherapy only group (40.9% vs 21.3%). Conclusions These results show that young women diagnosed with breast cancer experienced only a short-term decrease in QoL from the addition of goserelin, in order to preserve ovarian function during chemotherapy treatment.

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“…A strategy to reduce the risk of treatment-induced premature menopause includes suppressing the ovaries temporarily with a GnRH analog during chemotherapy as chemotherapy-induced menopause rises with increasing age. 7 The risk of infertility is higher for women greater than 35 years of age while using different adjuvant/neoadjuvant chemotherapy regimens ranging from 60 to 100% while for women less than 35 years of age infertility ranges from 5-50%. 8 Patients who received chemotherapy plus LH-RH analog have a rate of premature ovarian insufficiency more than twice as high in patients receiving chemotherapy.…”

Section: Ovarian Function Suppression With Chemotherapymentioning

confidence: 99%

<p>Controversies Regarding Ovarian Suppression and Infertility in Early Stage Breast Cancer</p>

Durrani

Heena

2020

CMAR

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A common side effect of chemotherapy in breast cancer is early menopause in premenopausal patients, which is mainly a result of an indirect form of ovarian ablation, and is associated with substantial impairment of quality of life. Suppressing the production of ovarian estrogen has been shown to reduce the recurrence of hormone receptor-positive early breast cancer in premenopausal women, but whether it has an added advantage over tamoxifen is being discussed. Types of permanent ablation of the ovarian function include surgical oophorectomy and radiation-induced ovarian failure. Both are associated with similar response rates in hormone receptor-positive metastatic breast cancer. Medical castration with luteinizing hormone-releasing hormone analogs (LHRHa) has the benefit of being a reversible approach. Another advantage that premenopausal patients who wish to reduce the risk of developing premature ovarian insufficiency induced by chemotherapy may be offered LHRHa irrespective of whether they desire pregnancy and their age at diagnosis. This also helps reduce the risk of menopausal signs and symptoms as well as the loss of bone density in the long-term, which are primary concerns for women. This is of utmost importance to premenopausal women who do not want to conceive after treatment or are not candidates for fertility preservation strategies because of age. It should be emphasized that for women who are interested in fertility preservation, gamete cryopreservation remains the first option, and LHRHa is not an alternative. During chemotherapy, however, temporary ovarian suppression with LHRHa may be given to women who either have no access to a fertility clinic or who have declined chemotherapy or have contraindications.

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Impact of Chemotherapy-induced Menopause in Women of Childbearing Age With Non-metastatic Breast Cancer – Preliminary Results From the MENOCOR Study

Cited by 15 publications

References 42 publications

Anti-Müllerian Hormone and Ovarian Reserve: Update on Assessing Ovarian Function

Anti-Müllerian Hormone and Ovarian Reserve: Update on Assessing Ovarian Function

The affect of goserelin on the QoL of women having chemotherapy for EBC: Results from the OPTION trial

<p>Controversies Regarding Ovarian Suppression and Infertility in Early Stage Breast Cancer</p>

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