Gonadotropin-releasing hormone analogues for the prevention of chemotherapy-induced premature ovarian failure in breast cancer patients

Abstract Purpose: We examined whether there were differences in major depression outcomes and independent risk factors associated with gonadotropin-releasing hormone agonists (GnRHa) and ovarian ablation (OA) in premenopausal breast cancer patients. Methods: Premenopausal breast cancer patients from seven hospitals who received OFS participated in the study between June 2019 and June 2020. The independent variable was the type of ovarian suppression, categorized as either OA (n = 174) or GnRHa (n = 389). Major depression was evaluated using the Patient Health Questionnaire (PHQ-9), and the Female Sexual Function Index questionnaire was used to assess sexual function.Results: A total of 563 patients completed the surveys. The mean PHQ-9 sum score was slightly lower in the GnRHa cohort than in the OA cohort (11.4 ± 5.7 vs. 12.8 ± 5.8, P = 0.079). There were significantly fewer patients with major depression (PHQ-9 ≥ 15) in the GnRHa cohort (31.1% vs. 40.2%, P = 0.025). Further, the duration of OFS was closely correlated with major depression, indicating a time-dependent trend [duration of OFS > 2 years vs. duration of OFS ≤ 2 years: Exp (B) = 1.651, P = 0.031]. Sexual dysfunction was negatively correlated with major depression [sexual dysfunction vs. normal: Exp (B) = 0.769, P = 0.046].Conclusions: This is the first study to demonstrate that GnRHa results in more favorable depression outcomes than OA. Moreover, most patients preferred alternatives to their OFS treatment. These findings can contribute to improving and alleviating the adverse effects of OFS.

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Chemotherapy-induced premature ovarian failure and its prevention in premenopausal breast cancer patients

Expert Review of Quality of Life in Cancer Care ◽

10.1080/23809000.2016.1139458 ◽

2016 ◽

Vol 1 (1) ◽

pp. 5-7 ◽

Cited By ~ 12

Author(s):

Francesca Poggio ◽

Alessia Levaggi ◽

Matteo Lambertini

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Premature Ovarian Failure ◽

Ovarian Failure ◽

Breast Cancer Patients ◽

Premenopausal Breast Cancer

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Abstract GS4-01: Pooled analysis of five randomized trials investigating temporary ovarian suppression with gonadotropin-releasing hormone analogs during chemotherapy as a strategy to preserve ovarian function and fertility in premenopausal early breast cancer patients

10.1158/1538-7445.sabcs17-gs4-01 ◽

2018 ◽

Cited By ~ 10

Author(s):

M Lambertini ◽

HCF Moore ◽

RCF Leonard ◽

S Loibl ◽

P Munster ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Early Breast Cancer ◽

Randomized Trials ◽

Ovarian Function ◽

Pooled Analysis ◽

Gonadotropin Releasing Hormone ◽

Breast Cancer Patients ◽

Releasing Hormone ◽

Hormone Analogs

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Preservation of Ovarian Function and Minimizing Premature Ovarian Failure during Chemotherapy Using Gonadotropin-Releasing Hormone Analogs

Women s Health ◽

10.2217/whe.11.72 ◽

2011 ◽

Vol 7 (6) ◽

pp. 635-640 ◽

Cited By ~ 2

Author(s):

Zeev Blumenfeld

Keyword(s):

Breast Cancer ◽

Premature Ovarian Failure ◽

Group Versus ◽

Ovarian Failure ◽

Gonadotropin Releasing Hormone ◽

Phase Iii ◽

Absolute Difference ◽

Early Menopause ◽

Releasing Hormone ◽

Hormone Analog

Evaluation of: Del Mastro L, Boni L, Michelotti A et al. Effect of the gonadotropin-releasing hormone analogue triptorelin on the occurrence of chemotherapy-induced early menopause in premenopausal women with breast cancer: a randomized trial. JAMA 306(3), 269–276 (2011). This study is a randomized, open-label, Phase III trial, conducted in 16 Italian centers that enrolled 281 patients between 2003 and 2008. The recruited patients were prospectively and randomly allocated to either chemotherapy alone or combined with monthly triptorelin gonadotropin-releasing hormone analog, started before chemotherapy and repeated every month throughout chemotherapy. The clinical and tumor characteristics of the patients in the control or treatment groups were similar. A total of 12 months after ending chemotherapy, the premature ovarian failure rate was 25.9% in the chemotherapy-alone group versus 8.9% in the chemotherapy and gonadotropin-releasing hormone analog group, an absolute difference of −17% (95% CI: −26 to −7.9%; p < 0.001). The odds ratio for treatment-induced premature ovarian failure was 0.28 (95% CI: 0.14–0.59; p < 0,001). The authors concluded that use of gonadotropin-releasing hormone analog chemotherapy in premenopausal breast cancer patients can significantly reduce the occurrence of chemotherapy-induced early menopause.

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