Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Jul;212(1):79-86.
doi: 10.1007/s10549-025-07702-w. Epub 2025 Apr 22.

Impact of pembrolizumab on ovarian function in young triple-negative breast cancer patients treated with chemo-immunotherapy

Anne Perdrix  1   2 , Nathalie Olympios  3 , Jean Rouvet  4 , Marie Degremont  1   5 , Camille Fontaine  1   5 , Baptiste Boitel  1 , Roman Vion  3 , Marianne Leheurteur  3 , Florian Clatot  6   7
Affiliations

Impact of pembrolizumab on ovarian function in young triple-negative breast cancer patients treated with chemo-immunotherapy

Anne Perdrix et al. Breast Cancer Res Treat. 2025 Jul.

Abstract

Purpose: Pembrolizumab plus neoadjuvant chemotherapy (P-CT) is the new standard in early-stage triple-negative breast cancers (TNBC). Pembrolizumab impact on ovarian reserve remained unknown. We evaluated the impact of pembrolizumab on ovarian reserve, through plasmatic Anti-Müllerian (AMH) analysis, in young TNBC patients.

Methods: TNBC patients < 43 years treated by P-CT (carboplatin/paclitaxel/epirubicin/cyclophosphamide plus pembrolizumab) of which plasma samples were available before and after treatment were included retrospectively (P-CT group). AMH, FSH, and estradiol were analyzed before and after treatment, then compared to a retrospective cohort of TNBC patients treated with chemotherapy alone (cyclophosphamide/anthracycline/taxanes) (No-P group).

Results: P-CT patients (N = 17) and No-P patients (N = 62) had comparable median age, BMI, smoking exposure, BRCA status, oral hormonal contraceptive use at diagnosis, and baseline AMH. Drugs used were comparable in both groups, except for carboplatin and pembrolizumab, only used in P-CT group. One year after the start of treatment, AMH fell from 1.08 to 0.01 ng/mL (p = 0.0001) and from 1.39 to 0.018 ng/mL (p < 0.0001), in the P-CT and No-P groups, respectively, without difference according to pembrolizumab exposure (p = 0.25). 9/17 P-CT patients (53%), and 21/62 No-P patients (34%), had undetectable AMH after treatment (p = 0.25). FSH and estradiol were comparable between the two groups, before and after treatment.

Conclusion: No additional impact of pembrolizumab versus chemotherapy alone on AMH evolution was observed in TNBC patients < 43 years. Nevertheless, undetectable AMH 1 year after the start of treatment was common in the P-CT group. Larger studies are essential to confirm these preliminary results and assess long-term impact of pembrolizumab on ovarian reserve.

Keywords: AMH; Early-stage triple-negative breast cancer; Immune checkpoint inhibitor; Ovarian reserve; Pembrolizumab.

PubMed Disclaimer

Conflict of interest statement

Declarations. Competing interests: FC has received honoraria and/or travel grants from Astra Zeneca, Daiichi, Gilead, MSD, Merck Serono, Nutricia, Novartis outside the submitted work. ML has received payment of congress fees from Daiichi, Lilly, MSD, Pfizer, GSK, Novartis, Mundi pharma, EISAI; and has undertaken consultancy for MSD, Astra-Zeneca, Pierre Fabre, GSK, Lilly and Seagen outside the submitted work. NO has received payment of congress fees from Pfizer, Gillead and Lilly; and has undertaken consultancy for Gilead and Astra Zeneca outside the submitted work. The other authors report no potential conflicts of interest. Ethical approval: The present study follows the French reference methodology MR-004 and was approved by the Institutional Scientific and Ethics Committees of Henri Becquerel Center (registering order N°2406B). Consent to participate: All patients signed a consent form allowing the conservation and use of their biological samples. No patient objected to the use of the anonymous data generated for research purposes, according to MR-004 methodology. Consent to publish: This manuscript does not contain any individual personal data.

References

    1. Schmid P, Cortes J, Dent R et al (2022) Event-free survival with pembrolizumab in early triple-negative breast cancer. N Engl J Med 386:556–567. https://doi.org/10.1056/NEJMoa2112651 - DOI - PubMed
    1. Schmid P, Cortes J, Dent R et al (2024) Overall survival with pembrolizumab in early-stage triple-negative breast cancer. N Engl J Med 391:1981–1991. https://doi.org/10.1056/NEJMoa2409932 - DOI - PubMed
    1. Vaz-Luis I, Masiero M, Cavaletti G et al (2022) ESMO expert consensus statements on cancer survivorship: promoting high-quality survivorship care and research in Europe. Ann Oncol 33:1119–1133. https://doi.org/10.1016/j.annonc.2022.07.1941 - DOI - PubMed
    1. Howard FM, Olopade OI (2021) Epidemiology of triple-negative breast cancer: a review. Cancer J 27:8–16. https://doi.org/10.1097/PPO.0000000000000500 - DOI - PubMed - PMC
    1. Mailliez A, Pigny P, Bogart E et al (2022) Is ovarian recovery after chemotherapy in young patients with early breast cancer influenced by controlled ovarian hyperstimulation for fertility preservation or tumor characteristics? Results of a prospective study in 126 patients. Int J Cancer 150:1850–1860. https://doi.org/10.1002/ijc.33933 - DOI - PubMed

MeSH terms

LinkOut - more resources