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Review
. 2019 Jul 31:13:1179558119864584.
doi: 10.1177/1179558119864584. eCollection 2019.

Potential Mechanisms of Ovarian Protection with Gonadotropin-Releasing Hormone Agonist in Breast Cancer Patients: A Review

Francesca Poggio  1 , Matteo Lambertini  2   3 , Claudia Bighin  1 , Benedetta Conte  1 , Eva Blondeaux  1 , Alessia D'Alonzo  1 , Chiara Dellepiane  1 , Giulia Buzzatti  1 , Chiara Molinelli  1 , Francesco Boccardo  2   3 , Lucia Del Mastro  1   3
Affiliations
Review

Potential Mechanisms of Ovarian Protection with Gonadotropin-Releasing Hormone Agonist in Breast Cancer Patients: A Review

Francesca Poggio et al. Clin Med Insights Reprod Health. .

Abstract

The use of chemotherapy in premenopausal cancer patients may lead to chemotherapy-induced premature ovarian failure. Pharmacological temporary ovarian suppression obtained with the gonadotropin-releasing hormone agonist (GnRHa) administered concomitantly with chemotherapy has been investigated as a technique capable to reduce the gonadotoxicity, reducing the risk of developing premature menopause. In recent years, important evidence has become available on the efficacy and safety of this strategy that should now be considered a standard option for ovarian function preservation in premenopausal breast cancer patients. However, in women interested in fertility preservation, this is not an alternative to cryopreservation strategies, which remains the first option to be proposed. The purpose of this review is to summarize the mechanisms of GnRHa in the preservation of fertility in premenopausal cancer patient candidates to receive chemotherapy, highlighting the areas of doubt that require further investigation.

Keywords: GnRHa; chemotherapy; fertility; ovarian function; premenopausal patients.

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Conflict of interest statement

Declaration of Conflicting Interests:The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Lucia Del Mastro received honoraria from Takeda and personal fees from Ipsen and Takeda outside the submitted work. Matteo Lambertini served as a consultant for Teva and received honoraria from Theramex outside the submitted work. All other authors declare no conflicts of interest.

Figures

Figure 1.
Figure 1.
GnRHa administration concomitantly with chemotherapy: conceivable mechanisms of ovarian protection (modified from). FSH indicates follicles-stimulating hormone; GnRHa, gonadotropin-releasing hormone agonist.
See this image and copyright information in PMC

References

    1. Lambertini M, Goldrat O, Clatot F, Demeestere I, Awada A. Controversies about fertility and pregnancy issues in young breast cancer patients: current state of the art. Curr Opin Oncol. 2017;29:243–252. doi:10.1097/CCO.0000000000000380. - DOI - PubMed
    1. Howard-Anderson J, Ganz PA, Bower JE, Stanton AL. Quality of life, fertility concerns, and behavioral health outcomes in younger breast cancer survivors: a systematic review. J Natl Cancer Inst. 2012;104:386–405. doi:10.1093/jnci/djr541. - DOI - PubMed
    1. Letourneau JM, Smith JF, Ebbel EE, et al. Racial, socioeconomic, and demographic disparities in access to fertility preservation in young women diagnosed with cancer. Cancer. 2012;118:4579–4588. doi:10.1002/cncr.26649. - DOI - PMC - PubMed
    1. Peccatori FA, Azim HA, Orecchia R, et al. Cancer, pregnancy and fertility: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2013;24:vi160-vi170. doi:10.1093/annonc/mdt199. - DOI - PubMed
    1. Oktay K, Harvey BE, Partridge AH, et al. Fertility preservation in patients with cancer: ASCO clinical practice guideline update. J Clin Oncol. 2018;36:1994–2001. doi:10.1200/JCO.2018.78.1914. - DOI - PubMed

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