Wendy S Vitek1, Michelle Shayne2, Kathleen Hoeger3, Yu Han4, Susan Messing4, Chunkit Fung2. 1. Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Rochester School of Medicine and Dentistry, Rochester, New York. Electronic address: wendy_vitek@urmc.rochester.edu. 2. Department of Hematology and Oncology, University of Rochester School of Medicine and Dentistry, Rochester, New York. 3. Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Rochester School of Medicine and Dentistry, Rochester, New York. 4. Department of Biostatistics and Computational Biology, University of Rochester, Rochester, New York.
Abstract
OBJECTIVE: To determine whether concurrent use of GnRH agonists with chemotherapy preserves ovarian function in women with breast cancer who did not use tamoxifen. DESIGN: Systematic review and meta-analysis. SETTING: University-based hospitals. PATIENT(S): Premenopausal women with breast cancer treated with chemotherapy who did not receive tamoxifen. INTERVENTION(S): Randomization to concurrent GnRH agonists with chemotherapy or chemotherapy alone. MAIN OUTCOME MEASURE(S): Odds ratio (OR) of resumption of menses 1 year or more after chemotherapy. RESULT(S): Searches were conducted in PubMed, Scopus, Cochrane Trials Register, and the National Research Register through March 2014, and all randomized trials that reported resumption of menses 1 year or more after GnRH agonist with chemotherapy or chemotherapy alone among women with breast cancer who did not receive tamoxifen were included. Four studies were analyzed in the meta-analysis and included 252 patients (GnRH agonist with chemotherapy, n=131; chemotherapy alone, n=121). There was no significant difference in the rate of return of menses between the two groups (OR, 1.47; 95% confidence interval [0.60-3.62]). Heterogeneity among the trials was not significant (I2=16.6%). CONCLUSION(S): Concurrent GnRH agonists with chemotherapy may not preserve ovarian function in women with breast cancer. Furthermore, randomized data are limited regarding fertility after concurrent use of GnRH agonists with chemotherapy.
OBJECTIVE: To determine whether concurrent use of GnRH agonists with chemotherapy preserves ovarian function in women with breast cancer who did not use tamoxifen. DESIGN: Systematic review and meta-analysis. SETTING: University-based hospitals. PATIENT(S): Premenopausal women with breast cancer treated with chemotherapy who did not receive tamoxifen. INTERVENTION(S): Randomization to concurrent GnRH agonists with chemotherapy or chemotherapy alone. MAIN OUTCOME MEASURE(S): Odds ratio (OR) of resumption of menses 1 year or more after chemotherapy. RESULT(S): Searches were conducted in PubMed, Scopus, Cochrane Trials Register, and the National Research Register through March 2014, and all randomized trials that reported resumption of menses 1 year or more after GnRH agonist with chemotherapy or chemotherapy alone among women with breast cancer who did not receive tamoxifen were included. Four studies were analyzed in the meta-analysis and included 252 patients (GnRH agonist with chemotherapy, n=131; chemotherapy alone, n=121). There was no significant difference in the rate of return of menses between the two groups (OR, 1.47; 95% confidence interval [0.60-3.62]). Heterogeneity among the trials was not significant (I2=16.6%). CONCLUSION(S): Concurrent GnRH agonists with chemotherapy may not preserve ovarian function in women with breast cancer. Furthermore, randomized data are limited regarding fertility after concurrent use of GnRH agonists with chemotherapy.
Authors: Rodrigo R Munhoz; Allan A L Pereira; André D Sasse; Paulo M Hoff; Tiffany A Traina; Clifford A Hudis; Ricardo J Marques Journal: JAMA Oncol Date: 2016-01 Impact factor: 31.777
Authors: Matteo Lambertini; Lucia Del Mastro; Maria C Pescio; Claus Y Andersen; Hatem A Azim; Fedro A Peccatori; Mauro Costa; Alberto Revelli; Francesca Salvagno; Alessandra Gennari; Filippo M Ubaldi; Giovanni B La Sala; Cristofaro De Stefano; W Hamish Wallace; Ann H Partridge; Paola Anserini Journal: BMC Med Date: 2016-01-04 Impact factor: 8.775
Authors: N Spears; F Lopes; A Stefansdottir; V Rossi; M De Felici; R A Anderson; F G Klinger Journal: Hum Reprod Update Date: 2019-11-05 Impact factor: 15.610