Long-Term Follow-Up of Chemotherapy-Induced Ovarian Failure in Young Breast Cancer Patients: The Role of Vascular Toxicity

Ben‐Aharon, Irit; Granot, Tal; Meizner, Israel; Hasky, Noa; Tobar, Ana; Rizel, Shulamith; Yerushalmi, Rinat; Ben-Haroush, Avi; Fisch, Benjamin; Stemmer, Salomon M.

doi:10.1634/theoncologist.2015-0044

Cited by 38 publications

(34 citation statements)

References 25 publications

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“…These authors also found that age was the most important risk factor for the occurrence of chemotherapy-induced amenorrhoea because the rate of amenorrhoea increased with increasing age. This finding was further corroborated by the work of Ben-Aharon et al [22], which showed that women under 35 years of age recovered from alterations in chemotherapy-induced ovarian circulation faster than their older counterparts. Menstrual disorders are likely to occur in women who already have some degree of aging ovarian function [23] [24].…”

Section: Discussionsupporting

confidence: 61%

Female Fertility Following Chemotherapy for Breast Cancer: A Descriptive Study of 265 Cases Treated in Yaounde

Essiben¹,

Kemfang²,

Nganso³

et al. 2020

OJOG

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Context: In Cameroon, breast cancer (BC) is usually diagnosed late in the disease course. About a third of women affected are aged less than 40 years. Chemotherapy (CT) could alter ovarian function and thereby compromise future fertility in these women. We therefore described the fertility of women following CT for BC in women treated at the Yaounde General Hospital (YGH). Methods: It was a retrospective, descriptive, cross-sectional study conducted over 8 months, from January to August 2017. We used the files of patients managed for BC from January 2011 to December 2015 in the medical oncology unit of the YGH. Results: We included 265 patients for the study following at least one year of CT. The mean age at the onset of CT was 35.9 ± 6.9 years. Most of the patients had fewer than 2 deliveries (68.3%). Intraductal carcinoma was the most frequent histological lesion (90.6%) and most often diagnosed in advanced stages (73.5%). As per CT, the FAC protocol was the most used (44.5%). The menstrual cycles of the patients were more regular prior to the onset of chemotherapy (89.4% vs. 58.9%), while the mean period of resumption of menstrual activity following cessation of chemotherapy was 6.3 ± 2.0 months. Chemotherapy-related amenorrhoea was observed in 29.1% of patients after 12 months of treatment.

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Section: Discussionsupporting

confidence: 61%

Female Fertility Following Chemotherapy for Breast Cancer: A Descriptive Study of 265 Cases Treated in Yaounde

Essiben¹,

Kemfang²,

Nganso³

et al. 2020

OJOG

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“…Experiments in rats showed that GnRHa inhibited estrogen-induced increase of ovarian perfusion and endothelial vessel area [20]. In humans, some studies reported a significant reduction in ovarian artery blood flow after short-and long-term administration of GnRHa [21,22], but others did not confirm these findings [23,24]. Although reducing the exposure to chemotherapy could have a protective effect on follicular pool, decreasing ovarian perfusion may also have a detrimental effect on chemotherapy-induced ovarian fibrosis.…”

Section: Indirect Effectmentioning

confidence: 99%

Ovarian protection with gonadotropin-releasing hormone agonists during chemotherapy in cancer patients: From biological evidence to clinical application

Lambertini

Horicks

Mastro

et al. 2019

Cancer Treatment Reviews

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Survivorship issues are an area of crucial importance to be addressed as early as possible by all health care providers dealing with cancer patients. In women diagnosed during their reproductive years, the possible occurrence of chemotherapy-induced premature ovarian insufficiency (POI) is of particular concern being associated with important menopause-related symptoms, psychosocial issues as well as infertility. Temporary ovarian suppression by administering a gonadotropin-releasing hormone agonist (GnRHa) during chemotherapy has been studied to reduce the gonadotoxic impact of chemotherapy thus diminishing the chance of developing POI. Despite more than 30 years of research in both preclinical and clinical settings, the performance of this strategy has remained highly debated until recently. In particular, the potential mechanisms of action for the protective effects of GnRHa during chemotherapy are still not clearly identified. Nevertheless, important novel research efforts in the field have better elucidated the role of this option that is now endorsed for clinical use by several guidelines. This manuscript aims at providing an extensive overview of the literature on the use of temporary ovarian suppression with GnRHa during chemotherapy in cancer patients by addressing its biological rationale, the available preclinical and clinical evidence as well as the still existing grey zones in this field that future research efforts should address.

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“…Long-term anxiety could cause dysfunction of the hypothalamic-pituitary-ovarian axis (HPOA), which can lead to DOR or premature ovarian failure (Nicoloro-SantaBarbara et al, 2017). Among these factors, alkylating chemotherapy agents, such as cyclophosphamide (CTX), which is highly gonad-toxic, led to a decrease in ovarian function and in anti-Müllerian hormone (AMH) (Ben-Aharon et al, 2015). It could induce ovarian damage by activation of the PI3K/AKT and mTOR pathways (Goldman et al, 2017), leading to primordial follicle activation and follicular "burnout" (Chang et al, 2015).…”

Section: Introductionmentioning

confidence: 99%

Protective Effects and Possible Mechanisms of Actions of Bushen Cuyun Recipe on Diminished Ovarian Reserve Induced by Cyclophosphamide in Rats

et al. 2020

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Backgrounds: Diminished ovarian reserve (DOR) contributes significantly to female infertility. Bushen Cuyun Recipe (BCR, Tradename Yueliang Yin), a product marketed in China, has shown effects in the treatment of female infertility in clinical practices of traditional Chinese medicine (TCM). In this study, we aimed to investigate the chemical compositions of BCR and its efficacy based on scientific evidence and pharmacological mechanisms in DOR treatments. Methods: The chemical compositions of BCR were determined by the UHPLC-LTQ-Orbitrap MS method. DOR was induced in a rat model by intraperitoneal injection of cyclophosphamide (CTX) 90 mg/kg once. After the CTX treatment for 14 days, rats were intragastrically administrated deionized water, dehydroepiandrosterone (DHEA), or BCR in low, middle, and high doses for 30 days. Ovarian index, ovarian morphology, follicle number, and anti-Müllerian hormone (AMH) in serum were determined to assess the effects of BCR. To investigate possible action mechanisms, network pharmacological analysis was used to predict possible pathways in the effects of BCR on female infertility. In experimental studies, the contents of hormones in the hypothalamic-pituitary-ovarian axis (HPOA, including estradiol (E 2), follicle-stimulating hormone (FSH), and gonadotropinreleasing hormone (GnRH)) and pyroptosis-related proteins, including gasdermin D (GSDMD), caspase-1, and interleukin-18 (IL-18), in ovarian were detected by ELISA, immunofluorescence and Western blot. Results: Chemical studies revealed a total 84 components in BCR, which included 43 flavonoids, 13 triterpenoids, 11 phenolic acids, 8 alkaloids, 1 coumarin, 1 anthraquinone, and 7 other components. After treatments with BCR, the ovarian morphology, ovarian index, estrous cycle, growing follicles and corpus luteum from last ovulation, and serum AMH in DOR rats were significantly improved. Network pharmacological analysis suggested that the NOD-like receptor signaling pathway ranked No. 1 among the mechanisms by which BCR affects female infertility. Experimental results demonstrated

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Long-Term Follow-Up of Chemotherapy-Induced Ovarian Failure in Young Breast Cancer Patients: The Role of Vascular Toxicity

Cited by 38 publications

References 25 publications

Female Fertility Following Chemotherapy for Breast Cancer: A Descriptive Study of 265 Cases Treated in Yaounde

Female Fertility Following Chemotherapy for Breast Cancer: A Descriptive Study of 265 Cases Treated in Yaounde

Ovarian protection with gonadotropin-releasing hormone agonists during chemotherapy in cancer patients: From biological evidence to clinical application

Protective Effects and Possible Mechanisms of Actions of Bushen Cuyun Recipe on Diminished Ovarian Reserve Induced by Cyclophosphamide in Rats

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