Management of Induced Menopause in Gynaecological Cancers and Their Challenges

Purohit, Prashant; Sassarini, Jennifer; Lumsden, Mary Ann

doi:10.1007/s13669-019-0262-x

Cited by 5 publications

(3 citation statements)

References 81 publications

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“…Gynecologic cancers affect the female reproductive organs, including the cervix, ovaries, uterus, vagina, and vulva. They account for approximately 11% of the newly diagnosed cancers in women in the United States and 18% globally [1]. The most common gynecologic malignancies occur in the uterus and endometrium (53%), ovaries (25%), and cervix (14%) [2].…”

Section: Introductionmentioning

confidence: 99%

The Latest Findings of PD-1/PD-L1 Inhibitor Application in Gynecologic Cancers

Kooshkaki

Derakhshani

Safarpour

et al. 2020

IJMS

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Gynecologic cancers account for approximately 11% of the newly diagnosed cancers in women in the United States and for 18% globally. The presence of tumor-infiltrating lymphocytes (TILs) influences the clinical outcome of cancer patients and immune checkpoint inhibitors (ICIs), including anti programmed cell death protein-1 (anti-PD-1), anti-programmed death-ligand 1 (anti-PD-L1), and anticytotoxic T-lymphocyte antigen 4 (anti-CTLA-4), which have been approved for treating different types of malignancies. Antibodies targeting the PD-1/PD-L1 checkpoint have shown dynamic and durable tumor regressions, suggesting a rebalancing of the host–tumor interaction. There are several the US food and drug administration (FDA)-approved ICIs targeting PD-1, including pembrolizumab and nivolumab, as well as those targeting PD-L1, including avelumab, atezolizumab, and durvalumab for melanoma, renal cell cancer, colorectal cancer, head and neck cancer, cervix cancer, urothelial cancer, and lung cancer. Current pre-clinical and clinical studies assessing PD-1/PD-L1 inhibitors in several gynecologic cancers have reported significant antitumor activity. In this review, we investigate pre-clinical and clinical studies that describe the safety and efficacy of anti-PD-1/PD-L1 antibodies, with a particular focus on ongoing clinical trials, analyzing the oncological outcome and adverse effects of ICIs in gynecologic cancers.

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Section: Introductionmentioning

confidence: 99%

The Latest Findings of PD-1/PD-L1 Inhibitor Application in Gynecologic Cancers

Kooshkaki

Derakhshani

Safarpour

et al. 2020

IJMS

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“…1,3 Patients who experience surgical menopause are also at higher risk for accelerated decline in cardiovascular and bone health, thereby increasing their morbidity and mortality. 4 Hormonal therapy (HT) provides symptom relief, improves quality of life (QoL) and reduces the risk of adverse health outcomes associated with premature menopause. Estrogen therapy is the most effective treatment for many bothersome menopause symptoms, such as vasomotor and genitourinary complaints.…”

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confidence: 99%

“…Surgical menopause is associated with increased severity and frequency of VMS and sexual dysfunction, as well as faster symptom onset than that with natural menopause 1,3 . Patients who experience surgical menopause are also at higher risk for accelerated decline in cardiovascular and bone health, thereby increasing their morbidity and mortality 4 …”

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confidence: 99%

Barriers to surgical menopause counseling in gynecologic cancers: a quantitative and qualitative study of patients and providers

et al. 2022

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Objective The objective of this study is to identify factors associated with receiving surgical menopause counseling in gynecologic cancer patients, as well as patient and provider perspectives, regarding surgical menopause counseling and management. Methods We conducted a single-institution mixed-method study combining retrospective chart review and patient and provider surveys. Patients younger than 51 years who experienced surgical menopause after gynecologic cancer treatment from January 2017 to December 2019 were surveyed in April 2021 about experiences with menopause counseling, barriers to care, and quality of life. We then reviewed charts of only patients who fully completed surveys. All gynecologic oncology providers were surveyed about surgical menopause practices. Logistic regression identified factors associated with receiving counseling. Results Sixty-six of 75 identified met inclusion criteria and received survey invitations. Thirty-five (53%) completed surveys. Sixty percent had documented surgical menopause counseling. Patients who were counseled were younger (43 vs 48.5 years, P = 0.005), more likely to have referrals for menopause care (12 vs 9, P = 0.036), more likely to have menopause providers other than oncology providers (14 vs 8, P = 0.001), and had fewer comorbidities. Decreasing age at surgery increased odds of counseling. Most reported continued menopause symptoms and quality of life disturbances. Half were satisfied with menopause care. Majority preferred counseling from oncology providers. Most providers always counseled on surgical menopause but cited lack of time as the primary obstacle for complete counseling. Conclusions Younger age at surgery increased odds of receiving surgical menopause counseling. Gynecologic cancer patients experienced significant menopause-related disturbances. Improved understanding of patient and provider preferences and greater emphases on surgical menopause and survivorship will improve care for gynecologic oncology patients.

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