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Furlanetto J, Marmé F, Thode C, Nekljudova V, Liu Y, Martin Jimenez M, Reimer T, Knudsen E, Denkert C, Bassy M, Martin LA, Karn T, Sinn B, Filipitis M, van Mackelenbergh M, Fasching P, Müller V, Stickeler E, Schem C, Loibl S. 60MO Ovarian function in young patients (pts) treated with postneoadjuvant palbociclib (PAL) and endocrine therapy (ET) for hormone receptor (HR)-positive, HER2-negative early breast cancer (BC): Explorative analysis in Penelope-B. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.03.076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Furlanetto J, Marmé F, Seiler S, Thode C, Untch M, Schmatloch S, Schneeweiss A, Bassy M, Fasching PA, Strik D, Stickeler E, Schem C, Karn T, Grischke EM, Denkert C, van Mackelenbergh M, Müller V, Nekljudova V, Loibl S. Chemotherapy-induced ovarian failure in young women with early breast cancer: Prospective analysis of four randomised neoadjuvant/adjuvant breast cancer trials. Eur J Cancer 2021; 152:193-203. [PMID: 34116270 DOI: 10.1016/j.ejca.2021.04.038] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 04/19/2021] [Accepted: 04/22/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Young women receiving chemotherapy for early breast cancer (EBC) have a high probability for ovarian failure, defined by chemotherapy-induced amenorrhea (CIA) as a surrogate. CIA is insufficiently reliable and reproducible. We analysed chemotherapy-induced ovarian failure (CIOF) by assessing hormone parameters, CIA, and antral follicle count (AFC). METHODS Blood samples of women aged ≤45 years treated with anthracycline/taxane-based chemotherapy for EBC from four neoadjuvant/adjuvant trials were collected at baseline, at the end of treatment (EOT), and at 6, 12, 18, and 24 months after EOT. Centrally assessed oestradiol (cutoff <52.2 ng/L) and follicle-stimulating hormone (cutoff >12.4IU/L) were used to define CIOF for patients with baseline premenopausal hormone levels, anti-Müllerian hormone (AMH), and AFC to assess ovarian reserve. Further analyses included CIA, regain of premenopausal hormone levels, and disease-free survival (DFS) also in subgroups. RESULTS Six hundred ninety-six patients aged ≤45 years had premenopausal hormone levels at baseline. Overall, 85.1% (592/696) experienced CIOF at EOT, and 147 of 592 had further hormone measurements after EOT. Of those, 32.7% (48/147) regained premenopausal hormone levels after 6 months, 57.9% (66/114) regained premenopausal hormone levels after 12 months, 83.0% (73/88) regained premenopausal hormone levels after 18 months, and 89.2% (74/83) regained premenopausal hormone levels after 24 months. After 24 months, 72.4% (21/29) of patients without CIOF and 100% (14/14) with CIOF had low AMH levels. Four-year DFS without CIOF versus CIOF was 65.9% versus 84.6% (hazard ratio [HR] = 2.09, 95% confidence interval [CI]: 1.37-3.19; P < 0.001); in hormone receptor positive 61.8% versus 87.5% (HR = 2.69, 95% CI: 1.57-4.60; P < 0.001); in <30 years 68.3% versus 92.6% (HR = 4.87, 95% CI: 1.05-22.63; P = 0.026). CONCLUSION Most premenopausal women experienced CIOF after chemotherapy for EBC. After 2 years, nearly all regain premenopausal hormone levels. CIOF was associated with better DFS, especially in patients with hormone receptor-positive EBC or aged <30 years.
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Affiliation(s)
| | | | | | - Christian Thode
- Amedes MVZ Wagnerstibbe für Laboratoriumsmedizin, Medizinische Mikrobiologie und Immunologie, Göttingen, Germany
| | | | | | | | - Martina Bassy
- Amedes MVZ Wagnerstibbe für Laboratoriumsmedizin, Medizinische Mikrobiologie und Immunologie, Göttingen, Germany
| | | | | | | | | | | | | | - Carsten Denkert
- Institut für Pathologie Philipps-Universität Marburg, Germany
| | - Marion van Mackelenbergh
- Universitätsklinikum Schleswig-Holstein, Klinik für Gynäkologie und Geburtshilfe, Schleswig-Holstein, Germany
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Furlanetto J, Nekljudova V, Schneeweiss A, Thode C, Denkert C, Untch M, Bassy M, Karn T, Fasching P, Stickeler E, Schem C, Marmé F, Grischke EM, van Mackelenbergh M, Strik D, Schmatloch S, Müller V, Loibl S. Impact of chemotherapy-induced ovarian failure (CIOF) on disease-free survival (DFS) and overall survival (OS) in young women with early breast cancer (EBC). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz240.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Lange K, Achenbach P, Assfalg R, Bassy M, Bechthold-Dalla Pozza S, Böcker D, Braig S, Dietz B, Dunstheimer D, Eber S, Ermer U, Gavazzeni A, Gerstl EM, Götz M, Haupt F, Haus G, Heinrich M, Heublein A, Huhn F, Jolink M, Kick K, Knopff A, Koch C, Koch R, Kuhnle-Krahl U, Kriesen Y, Landendörfer W, Lang M, Laub O, Leipold G, Leppik KH, Müller H, Nellen-Hellmuth N, Ockert C, Raminger C, Renner C, Schulzik L, Sindichakis M, Tretter S, Warncke K, Winkler C, Zeller S, Ziegler AG, Müller I. Screening auf positive diabetes-spezifische Antikörper bei Kindern in Bayern (Fr1da-Projekt): psychische Folgen der Diagnose „früher Typ-1-Diabetes“ für Eltern. DIABETOL STOFFWECHS 2018. [DOI: 10.1055/s-0038-1641792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- K Lange
- Medizinische Hochschule Hannover, Medizinische Psychologie, Hannover, Germany
| | - P Achenbach
- Institut für Diabetesforschung, Helmholtz Zentrum München, München, Germany
| | - R Assfalg
- Institut für Diabetesforschung, Helmholtz Zentrum München, München, Germany
| | - M Bassy
- Medizinische Hochschule Hannover, Medizinische Psychologie, Hannover, Germany
| | | | - D Böcker
- Klinikum Nürnberg, Nürnberg, Germany
| | - S Braig
- Klinikum Bayreuth, Bayreuth, Germany
| | - B Dietz
- Berufsverband der Kinder- und Jugendärzte e.V. Bayern, München, Germany
| | | | - S Eber
- Berufsverband der Kinder- und Jugendärzte e.V. Bayern, München, Germany
| | - U Ermer
- Kliniken St. Elisabeth, Neuburg/Donau, Germany
| | - A Gavazzeni
- Kinderarztpraxis Bogenhausen, München, Germany
| | - EM Gerstl
- Klinikum Dritter Orden, Passau, Germany
| | - M Götz
- Berufsverband der Kinder- und Jugendärzte e.V. Bayern, Elisabethszell, Germany
| | - F Haupt
- Institut für Diabetesforschung, Helmholtz Zentrum München, München, Germany
| | - G Haus
- PaedNetz Bayern e.V., München, Germany
| | - M Heinrich
- Institut für Diabetesforschung, Helmholtz Zentrum München, München, Germany
| | - A Heublein
- Institut für Diabetesforschung, Helmholtz Zentrum München, München, Germany
| | - F Huhn
- Medizinische Hochschule Hannover, Medizinische Psychologie, Hannover, Germany
| | - M Jolink
- Institut für Diabetesforschung, Helmholtz Zentrum München, München, Germany
| | - K Kick
- Institut für Diabetesforschung, Helmholtz Zentrum München, München, Germany
| | - A Knopff
- Institut für Diabetesforschung, Helmholtz Zentrum München, München, Germany
| | - C Koch
- Institut für Diabetesforschung, Helmholtz Zentrum München, München, Germany
| | - R Koch
- Leopoldina Hospital, Schweinfurt, Germany
| | | | - Y Kriesen
- Institut für Diabetesforschung, Helmholtz Zentrum München, München, Germany
| | - W Landendörfer
- Berufsverband der Kinder- und Jugendärzte e.V. Bayern, Nürnberg, Germany
| | - M Lang
- Berufsverband der Kinder- und Jugendärzte e.V. Bayern, Augsburg, Germany
| | - O Laub
- Berufsverband der Kinder- und Jugendärzte e.V. Bayern, Rosenheim, Germany
| | - G Leipold
- Berufsverband der Kinder- und Jugendärzte e.V. Bayern, Regensburg, Germany
| | - KH Leppik
- Berufsverband der Kinder- und Jugendärzte e.V. Bayern, Erlangen, Germany
| | - H Müller
- Klinikum Kempten, Kempten, Germany
| | | | - C Ockert
- RoMed Klinikum, Rosenheim, Germany
| | - C Raminger
- Institut für Diabetesforschung, Helmholtz Zentrum München, München, Germany
| | - C Renner
- Praxis Kinder- und Jugendmedizin, Deggendorf, Germany
| | - L Schulzik
- Institut für Diabetesforschung, Helmholtz Zentrum München, München, Germany
| | | | | | - K Warncke
- Abteilung Pädiatrie, Klinikum rechts der Isar, München, Germany
| | - C Winkler
- Institut für Diabetesforschung, Helmholtz Zentrum München, München, Germany
| | - S Zeller
- Berufsverband der Kinder- und Jugendärzte e.V. Bayern, Kempten, Germany
| | - AG Ziegler
- Institut für Diabetesforschung, Helmholtz Zentrum München, München, Germany
| | - I Müller
- Medizinische Hochschule Hannover, Medizinische Psychologie, Hannover, Germany
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Furlanetto J, Thode C, Huober J, Denkert C, Bassy M, Hanusch C, Jackisch C, Kümmel S, Schneeweiss A, Untch M, Fasching PA, Karn T, Marmé F, van Mackelenbergh M, Müller V, Schem C, von Minckwitz G, Strik D, Nekljudova V, Loibl S. Abstract PD7-09: Changes in hormone levels (E2, FSH, AMH) and fertility of young women treated with neoadjuvant chemotherapy (CT) for early breast cancer (EBC). Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-pd7-09] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background:
We previously demonstrated that the majority of women ≤45 years experienced chemotherapy-induced ovarian failure (CIOF) after CT for EBC. Age, CT regimen, duration and dose-density influenced the rate of CIOF. The regain of premenopausal Follicle-Stimulating Hormone (FSH) and Estradiol (E2) levels after chemotherapy is not equivalent to fertility restoration. The Anti-Muellerian Hormone (AMH) assessment seems to be more accurate than other hormones in predicting the ovarian reserve. FSH, E2 and AMH have been prospectively assessed in young patients receiving (neo)adjuvant CT.
Methods:
740 patients (pts) aged ≤45yrs treated with anthracycline or taxane-based CT for EBC from 4 German neoadjuvant/adjuvant trials were included. Blood samples were collected at baseline before CT (N=740), end of treatment (EOT n=740), 6 (n=177), 12 (n=113), 18 (n=69), 24 (n=47) months (m) after EOT. Only the full set of samples of a given patient was included. FSH, E2 and AMH were centrally assessed. Postmenopausal hormone levels of FSH and E2 according to the central laboratory were defined as FSH>12.4IU/l and E2<52.2ng/l; fertile level of AMH as ≥0.22ng/ml. Regain of premenopausal hormone levels was defined as the time point from EOT to premenopausal FSH and E2 level regain and was assessed only for those pts with postmenopausal FSH and E2 levels at EOT. Pts with no regain have been censored at the date of the last hormone assessment.
Results:
Median age was 40yrs (range 21-45); 57.2% had BMI 18.5-<25, 41.1% ≥25; 32% had luminal-like, 35.9% HER2+, 32.0% triple-negative BC. Median hormone levels at different time points are presented in Table 1. Before chemotherapy 14.2% of pts had non-fertile hormone levels of AMH despite premenopausal levels of FSH and E2 compared to 77.3% of pts with postmenopausal levels (p<0.001); at EOT 77.4% vs 99.8% (p<0.001); at 6m 82.1% vs 100% (p<0.001); at 12m 80.7% vs 98.4% (p=0.002); at 18m 66.7% vs 100% (p<0.001); at 24 m 72.4% vs 100% (p=0.017). Similar results were observed in 47 pts with all time point samples available. Of 147 pts with postmenopausal hormone levels of FSH and E2 at EOT, 32.7% (95%CI 25.7%-40.9%) regained premenopausal hormone levels within 6m, 51.0% (95%CI 42.3%-60.4%) within 12m, 66.6% (95%CI 55.2%-77.6%) within 18m and 69.9% (95%CI 57.8%-81.3%) within 24m.
Conclusion:
Nearly 70% of women regain premenopausal hormone levels of FSH and E2 within 2 years after end of CT. Despite that, only less than one third maintain their fertility potential as predicted by AMH. AMH is a very sensitive marker for the prediction of fertility function after CT for EBC.
Table 1 Median and range of FSH, E2 and AMH levels per time pointsTimepointFSH,IU/lE2, ng/mLAMH, ng/ml% of pts with AMH levels above dtBaseline6.0 [dt-142.7]88.0 [dt-2375.0]0.96 [dt-16.18]95.4EOT76.1 [1.9-225.0]dt [dt-632.0]dt [dt -3.11]15.66 m41.4 [1.1-190.6]10.0 [dt-929.0]dt [dt -3.11]26.112 m28.7 [1.1-146.0]11.0 [dt-947.0]dt [dt -2.81]29.218 m20.6 [0.8-172.3]19.0 [dt-624.0]dt [dt -1.89]34.824 m16.30 [dt-93.9]44.0 [dt-11795.0]dt [dt -1.75]38.3Abbreviations: dt, detectable threshold, EOT, end of treatment; m, month; pts, patients. Detectable threshold: FSH<0.1IU/l, E2<5ng/l, AMH<0.03ng/ml
Citation Format: Furlanetto J, Thode C, Huober J, Denkert C, Bassy M, Hanusch C, Jackisch C, Kümmel S, Schneeweiss A, Untch M, Fasching PA, Karn T, Marmé F, van Mackelenbergh M, Müller V, Schem C, von Minckwitz G, Strik D, Nekljudova V, Loibl S. Changes in hormone levels (E2, FSH, AMH) and fertility of young women treated with neoadjuvant chemotherapy (CT) for early breast cancer (EBC) [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr PD7-09.
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Affiliation(s)
- J Furlanetto
- German Breast Group Neu-Isenburg; Amedes MVZ Wagnerstibbe für Laboratoriumsmedizin, Medizinische Mikrobiologie und Immunologie Göttingen; Universitätsklinikum Ulm; Charite Berlin; Klinikum zum Roten Kreuz München; SANA Klinikum Offenbach; Kliniken Essen-Mitte; Universitätsklinikum Heidelberg; Helios Kliniken Berlin-Buch; University Hospital Erlangen; Universitätsklinikum Frankfurt; Universitätsklinikums Schleswig-Holstein Kiel; Universitätsklinikum Hamburg; Endokrinologikum Berlin
| | - C Thode
- German Breast Group Neu-Isenburg; Amedes MVZ Wagnerstibbe für Laboratoriumsmedizin, Medizinische Mikrobiologie und Immunologie Göttingen; Universitätsklinikum Ulm; Charite Berlin; Klinikum zum Roten Kreuz München; SANA Klinikum Offenbach; Kliniken Essen-Mitte; Universitätsklinikum Heidelberg; Helios Kliniken Berlin-Buch; University Hospital Erlangen; Universitätsklinikum Frankfurt; Universitätsklinikums Schleswig-Holstein Kiel; Universitätsklinikum Hamburg; Endokrinologikum Berlin
| | - J Huober
- German Breast Group Neu-Isenburg; Amedes MVZ Wagnerstibbe für Laboratoriumsmedizin, Medizinische Mikrobiologie und Immunologie Göttingen; Universitätsklinikum Ulm; Charite Berlin; Klinikum zum Roten Kreuz München; SANA Klinikum Offenbach; Kliniken Essen-Mitte; Universitätsklinikum Heidelberg; Helios Kliniken Berlin-Buch; University Hospital Erlangen; Universitätsklinikum Frankfurt; Universitätsklinikums Schleswig-Holstein Kiel; Universitätsklinikum Hamburg; Endokrinologikum Berlin
| | - C Denkert
- German Breast Group Neu-Isenburg; Amedes MVZ Wagnerstibbe für Laboratoriumsmedizin, Medizinische Mikrobiologie und Immunologie Göttingen; Universitätsklinikum Ulm; Charite Berlin; Klinikum zum Roten Kreuz München; SANA Klinikum Offenbach; Kliniken Essen-Mitte; Universitätsklinikum Heidelberg; Helios Kliniken Berlin-Buch; University Hospital Erlangen; Universitätsklinikum Frankfurt; Universitätsklinikums Schleswig-Holstein Kiel; Universitätsklinikum Hamburg; Endokrinologikum Berlin
| | - M Bassy
- German Breast Group Neu-Isenburg; Amedes MVZ Wagnerstibbe für Laboratoriumsmedizin, Medizinische Mikrobiologie und Immunologie Göttingen; Universitätsklinikum Ulm; Charite Berlin; Klinikum zum Roten Kreuz München; SANA Klinikum Offenbach; Kliniken Essen-Mitte; Universitätsklinikum Heidelberg; Helios Kliniken Berlin-Buch; University Hospital Erlangen; Universitätsklinikum Frankfurt; Universitätsklinikums Schleswig-Holstein Kiel; Universitätsklinikum Hamburg; Endokrinologikum Berlin
| | - C Hanusch
- German Breast Group Neu-Isenburg; Amedes MVZ Wagnerstibbe für Laboratoriumsmedizin, Medizinische Mikrobiologie und Immunologie Göttingen; Universitätsklinikum Ulm; Charite Berlin; Klinikum zum Roten Kreuz München; SANA Klinikum Offenbach; Kliniken Essen-Mitte; Universitätsklinikum Heidelberg; Helios Kliniken Berlin-Buch; University Hospital Erlangen; Universitätsklinikum Frankfurt; Universitätsklinikums Schleswig-Holstein Kiel; Universitätsklinikum Hamburg; Endokrinologikum Berlin
| | - C Jackisch
- German Breast Group Neu-Isenburg; Amedes MVZ Wagnerstibbe für Laboratoriumsmedizin, Medizinische Mikrobiologie und Immunologie Göttingen; Universitätsklinikum Ulm; Charite Berlin; Klinikum zum Roten Kreuz München; SANA Klinikum Offenbach; Kliniken Essen-Mitte; Universitätsklinikum Heidelberg; Helios Kliniken Berlin-Buch; University Hospital Erlangen; Universitätsklinikum Frankfurt; Universitätsklinikums Schleswig-Holstein Kiel; Universitätsklinikum Hamburg; Endokrinologikum Berlin
| | - S Kümmel
- German Breast Group Neu-Isenburg; Amedes MVZ Wagnerstibbe für Laboratoriumsmedizin, Medizinische Mikrobiologie und Immunologie Göttingen; Universitätsklinikum Ulm; Charite Berlin; Klinikum zum Roten Kreuz München; SANA Klinikum Offenbach; Kliniken Essen-Mitte; Universitätsklinikum Heidelberg; Helios Kliniken Berlin-Buch; University Hospital Erlangen; Universitätsklinikum Frankfurt; Universitätsklinikums Schleswig-Holstein Kiel; Universitätsklinikum Hamburg; Endokrinologikum Berlin
| | - A Schneeweiss
- German Breast Group Neu-Isenburg; Amedes MVZ Wagnerstibbe für Laboratoriumsmedizin, Medizinische Mikrobiologie und Immunologie Göttingen; Universitätsklinikum Ulm; Charite Berlin; Klinikum zum Roten Kreuz München; SANA Klinikum Offenbach; Kliniken Essen-Mitte; Universitätsklinikum Heidelberg; Helios Kliniken Berlin-Buch; University Hospital Erlangen; Universitätsklinikum Frankfurt; Universitätsklinikums Schleswig-Holstein Kiel; Universitätsklinikum Hamburg; Endokrinologikum Berlin
| | - M Untch
- German Breast Group Neu-Isenburg; Amedes MVZ Wagnerstibbe für Laboratoriumsmedizin, Medizinische Mikrobiologie und Immunologie Göttingen; Universitätsklinikum Ulm; Charite Berlin; Klinikum zum Roten Kreuz München; SANA Klinikum Offenbach; Kliniken Essen-Mitte; Universitätsklinikum Heidelberg; Helios Kliniken Berlin-Buch; University Hospital Erlangen; Universitätsklinikum Frankfurt; Universitätsklinikums Schleswig-Holstein Kiel; Universitätsklinikum Hamburg; Endokrinologikum Berlin
| | - PA Fasching
- German Breast Group Neu-Isenburg; Amedes MVZ Wagnerstibbe für Laboratoriumsmedizin, Medizinische Mikrobiologie und Immunologie Göttingen; Universitätsklinikum Ulm; Charite Berlin; Klinikum zum Roten Kreuz München; SANA Klinikum Offenbach; Kliniken Essen-Mitte; Universitätsklinikum Heidelberg; Helios Kliniken Berlin-Buch; University Hospital Erlangen; Universitätsklinikum Frankfurt; Universitätsklinikums Schleswig-Holstein Kiel; Universitätsklinikum Hamburg; Endokrinologikum Berlin
| | - T Karn
- German Breast Group Neu-Isenburg; Amedes MVZ Wagnerstibbe für Laboratoriumsmedizin, Medizinische Mikrobiologie und Immunologie Göttingen; Universitätsklinikum Ulm; Charite Berlin; Klinikum zum Roten Kreuz München; SANA Klinikum Offenbach; Kliniken Essen-Mitte; Universitätsklinikum Heidelberg; Helios Kliniken Berlin-Buch; University Hospital Erlangen; Universitätsklinikum Frankfurt; Universitätsklinikums Schleswig-Holstein Kiel; Universitätsklinikum Hamburg; Endokrinologikum Berlin
| | - F Marmé
- German Breast Group Neu-Isenburg; Amedes MVZ Wagnerstibbe für Laboratoriumsmedizin, Medizinische Mikrobiologie und Immunologie Göttingen; Universitätsklinikum Ulm; Charite Berlin; Klinikum zum Roten Kreuz München; SANA Klinikum Offenbach; Kliniken Essen-Mitte; Universitätsklinikum Heidelberg; Helios Kliniken Berlin-Buch; University Hospital Erlangen; Universitätsklinikum Frankfurt; Universitätsklinikums Schleswig-Holstein Kiel; Universitätsklinikum Hamburg; Endokrinologikum Berlin
| | - M van Mackelenbergh
- German Breast Group Neu-Isenburg; Amedes MVZ Wagnerstibbe für Laboratoriumsmedizin, Medizinische Mikrobiologie und Immunologie Göttingen; Universitätsklinikum Ulm; Charite Berlin; Klinikum zum Roten Kreuz München; SANA Klinikum Offenbach; Kliniken Essen-Mitte; Universitätsklinikum Heidelberg; Helios Kliniken Berlin-Buch; University Hospital Erlangen; Universitätsklinikum Frankfurt; Universitätsklinikums Schleswig-Holstein Kiel; Universitätsklinikum Hamburg; Endokrinologikum Berlin
| | - V Müller
- German Breast Group Neu-Isenburg; Amedes MVZ Wagnerstibbe für Laboratoriumsmedizin, Medizinische Mikrobiologie und Immunologie Göttingen; Universitätsklinikum Ulm; Charite Berlin; Klinikum zum Roten Kreuz München; SANA Klinikum Offenbach; Kliniken Essen-Mitte; Universitätsklinikum Heidelberg; Helios Kliniken Berlin-Buch; University Hospital Erlangen; Universitätsklinikum Frankfurt; Universitätsklinikums Schleswig-Holstein Kiel; Universitätsklinikum Hamburg; Endokrinologikum Berlin
| | - C Schem
- German Breast Group Neu-Isenburg; Amedes MVZ Wagnerstibbe für Laboratoriumsmedizin, Medizinische Mikrobiologie und Immunologie Göttingen; Universitätsklinikum Ulm; Charite Berlin; Klinikum zum Roten Kreuz München; SANA Klinikum Offenbach; Kliniken Essen-Mitte; Universitätsklinikum Heidelberg; Helios Kliniken Berlin-Buch; University Hospital Erlangen; Universitätsklinikum Frankfurt; Universitätsklinikums Schleswig-Holstein Kiel; Universitätsklinikum Hamburg; Endokrinologikum Berlin
| | - G von Minckwitz
- German Breast Group Neu-Isenburg; Amedes MVZ Wagnerstibbe für Laboratoriumsmedizin, Medizinische Mikrobiologie und Immunologie Göttingen; Universitätsklinikum Ulm; Charite Berlin; Klinikum zum Roten Kreuz München; SANA Klinikum Offenbach; Kliniken Essen-Mitte; Universitätsklinikum Heidelberg; Helios Kliniken Berlin-Buch; University Hospital Erlangen; Universitätsklinikum Frankfurt; Universitätsklinikums Schleswig-Holstein Kiel; Universitätsklinikum Hamburg; Endokrinologikum Berlin
| | - D Strik
- German Breast Group Neu-Isenburg; Amedes MVZ Wagnerstibbe für Laboratoriumsmedizin, Medizinische Mikrobiologie und Immunologie Göttingen; Universitätsklinikum Ulm; Charite Berlin; Klinikum zum Roten Kreuz München; SANA Klinikum Offenbach; Kliniken Essen-Mitte; Universitätsklinikum Heidelberg; Helios Kliniken Berlin-Buch; University Hospital Erlangen; Universitätsklinikum Frankfurt; Universitätsklinikums Schleswig-Holstein Kiel; Universitätsklinikum Hamburg; Endokrinologikum Berlin
| | - V Nekljudova
- German Breast Group Neu-Isenburg; Amedes MVZ Wagnerstibbe für Laboratoriumsmedizin, Medizinische Mikrobiologie und Immunologie Göttingen; Universitätsklinikum Ulm; Charite Berlin; Klinikum zum Roten Kreuz München; SANA Klinikum Offenbach; Kliniken Essen-Mitte; Universitätsklinikum Heidelberg; Helios Kliniken Berlin-Buch; University Hospital Erlangen; Universitätsklinikum Frankfurt; Universitätsklinikums Schleswig-Holstein Kiel; Universitätsklinikum Hamburg; Endokrinologikum Berlin
| | - S Loibl
- German Breast Group Neu-Isenburg; Amedes MVZ Wagnerstibbe für Laboratoriumsmedizin, Medizinische Mikrobiologie und Immunologie Göttingen; Universitätsklinikum Ulm; Charite Berlin; Klinikum zum Roten Kreuz München; SANA Klinikum Offenbach; Kliniken Essen-Mitte; Universitätsklinikum Heidelberg; Helios Kliniken Berlin-Buch; University Hospital Erlangen; Universitätsklinikum Frankfurt; Universitätsklinikums Schleswig-Holstein Kiel; Universitätsklinikum Hamburg; Endokrinologikum Berlin
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Furlanetto J, Thode C, Bassy M, Denkert C, Hanusch C, Huober JB, Jackisch C, Kummel S, Schneeweiss A, Untch M, Fasching PA, Karn T, Marme F, van Mackelenbergh M, Müller V, Schem C, Von Minckwitz G, Strik D, Nekljudova V, Loibl S. Chemotherapy-induced ovarian failure (CIOF) in young women with early breast cancer (EBC). J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.10068] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
10068 Background: Women ≤45 years (yrs) treated with chemotherapy (CT) for EBC have a high risk of developing CIOF. Awareness of CIOF is essential for young women. Methods: 740 patients (pts) aged ≤45yrs treated with anthracycline or taxane-based CT for EBC from 4 German neoadjuvant/adjuvant trials were included. Blood samples were collected at baseline (N=740), end of treatment (EOT n=740), 6 (n=177), 12 (n=113), 18 (n=69), 24 (n=47) months (m) after EOT. Only samples collected in a time sequence were included. Estradiol (E2), Follicle-Stimulating Hormone (FSH) and Anti-Müllerian Hormone (AMH) were centrally assessed. CIOF was defined as FSH >12.4IU/l and E2 <52.2ng/ml and was analysed per timepoint and according to clinical and treatment-related variables. Results: Median age was 40yrs (range 21-45); 57.2% had BMI 18.5-<25, 41.1% ≥25; 32% had luminal, 35.9% HER2+, 32.0% triple-negative BC. Median hormone levels at baseline for pts <30yrs vs 30-40yrs vs ≥40yrs were: FSH 5.2IU/I vs 5.6IU/I vs 6.4IU/I; E2 101ng/l vs 86ng/l vs 88ng/l; AMH 2.14ng/ml vs 1.58ng/ml vs 0.53ng/ml. 85.7% of pts had CIOF at EOT, 62.2% at 6m, 54.0% at 12m, 43.5% at 18m, 38.3% at 24m. Similar results were observed in 47 pts with all timepoint samples available. Older vs younger pts had more frequently CIOF at EOT (≥40yrs 94.6%, 30-40yrs 82.0%, <30yrs 50.0%, p<0.001). CIOF at EOT was not influenced by BMI. CT agents impacted the rate of CIOF (p<0.001; Table 1). Higher rate of CIOF was associated with longer CT duration (12w 58.3%, 16-18w 94.5%, 24w 82.1%; p<0.001) and with dose-dense (ddEC-ddD, weekly PM(Cb), intense-dd (idd) EnPC) vs conventional dosed CT (P/nP-EC q3w, P, Cz) (94.5% vs 78.6%; p<0.001). Conclusions: The majority of young women experienced CIOF after CT for EBC. After 2 yrs 62% of the pts returned to premenopausal hormone levels. Age, CT regimen, duration and density influenced the rate of CIOF and should be taken into account when counseling young women who desire to maintain ovarian function. [Table: see text]
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Affiliation(s)
| | - Christian Thode
- Amedes Mvz Wagnerstibbe Für Laboratoriumsmedizin, Medizinische Mikrobiologie Und Immunologie, Goettingen, Germany
| | - Martina Bassy
- Amedes Mvz Wagnerstibbe Für Laboratoriumsmedizin, Medizinische Mikrobiologie Und Immunologie, Goettingen, Germany
| | - Carsten Denkert
- Charité Universitätsmedizin Berlin - Institut für Pathologie, Berlin, Germany
| | | | | | | | | | | | | | | | - Thomas Karn
- Department of Obstetrics and Gynecology, Goethe University, Frankfurt, Germany
| | - Frederic Marme
- National Center for Tumor Disease (NCT), Department of Gynecology, University of Heidelberg, Heidelberg, Germany
| | | | - Volkmar Müller
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Bassy M, Lange K, Ziegler AG, Klingensmith G, Schober E, Roth R, Bingley PJ, Rottenkolber M, Theil A, Peplow C, Eugster A, Eisenbarth G, Puff R, Hasford J, Achenbach P, Bonifacio E. Psychological impact on parents by participating in the Pre-POINT study. DIABETOL STOFFWECHS 2015. [DOI: 10.1055/s-0035-1549639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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