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Effect of Timing of Gonadotropin-Releasing Hormone Agonist Administration for Ovarian Protection in Patients with Breast Cancer

PURPOSE: This study was performed to investigate the effect of the interval between the start of gonadotropin-releasing hormone agonist (GnRHa) and the start of chemotherapy on ovarian protection in patients with breast cancer. METHODS: This was a prospective observational cohort study that included...

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Autores principales: Shin, Jae Jun, Choi, Young Min, Jun, Jong Kwan, Lee, Kyung-Hun, Kim, Tae-Yong, Han, Wonshik, Im, Seock-Ah
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Breast Cancer Society 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7311369/
https://www.ncbi.nlm.nih.gov/pubmed/32595989
http://dx.doi.org/10.4048/jbc.2020.23.e33
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author Shin, Jae Jun
Choi, Young Min
Jun, Jong Kwan
Lee, Kyung-Hun
Kim, Tae-Yong
Han, Wonshik
Im, Seock-Ah
author_facet Shin, Jae Jun
Choi, Young Min
Jun, Jong Kwan
Lee, Kyung-Hun
Kim, Tae-Yong
Han, Wonshik
Im, Seock-Ah
author_sort Shin, Jae Jun
collection PubMed
description PURPOSE: This study was performed to investigate the effect of the interval between the start of gonadotropin-releasing hormone agonist (GnRHa) and the start of chemotherapy on ovarian protection in patients with breast cancer. METHODS: This was a prospective observational cohort study that included 136 patients with breast cancer below 40 years who received GnRHa during chemotherapy for fertility preservation. Plasma anti-Müllerian hormone (AMH) levels were measured before chemotherapy (baseline) and after chemotherapy. Subjects were divided into 3 groups according to the interval between the start of GnRHa and the start of chemotherapy for analysis: 1–6 days, 7–13 days, and ≥ 14 days. The ratio of the post-chemotherapy AMH value to the baseline AMH (pcAMH) at each time point were compared among the 3 groups. Ranked analysis of covariance was used for statistical analysis, adjusted for age, body mass index (BMI), and the existence of polycystic ovaries (PCOs). In addition, recovery of ovarian function (AMH ≥ 1 ng/mL) at 12 months was evaluated. RESULTS: The median age of the patients was 32 years. There was no difference in the baseline AMH levels among the 3 groups (mean ± standard error: 5.0 ± 0.4 ng/mL [1–6 days], 5.3 ± 0.7 ng/mL [7–13 days], and 8.1 ± 1.3 ng/mL [≥ 14 days]; p = 0.250). The pcAMH at 3, 6, 12, 24, and 36 months were not significantly different among the 3 groups (p-values were 0.332, 0.732, 0.830, 0.148, and 0.393, respectively). In multivariate analysis, young age (p = 0.024), low BMI (p = 0.013), and the existence of PCO (p = 0.015) were predictors for AMH ≥ 1 ng/mL at 12 months. CONCLUSION: There was no difference in the ovarian protective effect according to the difference in the timing of administration of GnRHa.
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spelling pubmed-73113692020-06-25 Effect of Timing of Gonadotropin-Releasing Hormone Agonist Administration for Ovarian Protection in Patients with Breast Cancer Shin, Jae Jun Choi, Young Min Jun, Jong Kwan Lee, Kyung-Hun Kim, Tae-Yong Han, Wonshik Im, Seock-Ah J Breast Cancer Original Article PURPOSE: This study was performed to investigate the effect of the interval between the start of gonadotropin-releasing hormone agonist (GnRHa) and the start of chemotherapy on ovarian protection in patients with breast cancer. METHODS: This was a prospective observational cohort study that included 136 patients with breast cancer below 40 years who received GnRHa during chemotherapy for fertility preservation. Plasma anti-Müllerian hormone (AMH) levels were measured before chemotherapy (baseline) and after chemotherapy. Subjects were divided into 3 groups according to the interval between the start of GnRHa and the start of chemotherapy for analysis: 1–6 days, 7–13 days, and ≥ 14 days. The ratio of the post-chemotherapy AMH value to the baseline AMH (pcAMH) at each time point were compared among the 3 groups. Ranked analysis of covariance was used for statistical analysis, adjusted for age, body mass index (BMI), and the existence of polycystic ovaries (PCOs). In addition, recovery of ovarian function (AMH ≥ 1 ng/mL) at 12 months was evaluated. RESULTS: The median age of the patients was 32 years. There was no difference in the baseline AMH levels among the 3 groups (mean ± standard error: 5.0 ± 0.4 ng/mL [1–6 days], 5.3 ± 0.7 ng/mL [7–13 days], and 8.1 ± 1.3 ng/mL [≥ 14 days]; p = 0.250). The pcAMH at 3, 6, 12, 24, and 36 months were not significantly different among the 3 groups (p-values were 0.332, 0.732, 0.830, 0.148, and 0.393, respectively). In multivariate analysis, young age (p = 0.024), low BMI (p = 0.013), and the existence of PCO (p = 0.015) were predictors for AMH ≥ 1 ng/mL at 12 months. CONCLUSION: There was no difference in the ovarian protective effect according to the difference in the timing of administration of GnRHa. Korean Breast Cancer Society 2020-05-11 /pmc/articles/PMC7311369/ /pubmed/32595989 http://dx.doi.org/10.4048/jbc.2020.23.e33 Text en © 2020 Korean Breast Cancer Society https://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Shin, Jae Jun
Choi, Young Min
Jun, Jong Kwan
Lee, Kyung-Hun
Kim, Tae-Yong
Han, Wonshik
Im, Seock-Ah
Effect of Timing of Gonadotropin-Releasing Hormone Agonist Administration for Ovarian Protection in Patients with Breast Cancer
title Effect of Timing of Gonadotropin-Releasing Hormone Agonist Administration for Ovarian Protection in Patients with Breast Cancer
title_full Effect of Timing of Gonadotropin-Releasing Hormone Agonist Administration for Ovarian Protection in Patients with Breast Cancer
title_fullStr Effect of Timing of Gonadotropin-Releasing Hormone Agonist Administration for Ovarian Protection in Patients with Breast Cancer
title_full_unstemmed Effect of Timing of Gonadotropin-Releasing Hormone Agonist Administration for Ovarian Protection in Patients with Breast Cancer
title_short Effect of Timing of Gonadotropin-Releasing Hormone Agonist Administration for Ovarian Protection in Patients with Breast Cancer
title_sort effect of timing of gonadotropin-releasing hormone agonist administration for ovarian protection in patients with breast cancer
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7311369/
https://www.ncbi.nlm.nih.gov/pubmed/32595989
http://dx.doi.org/10.4048/jbc.2020.23.e33
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