https://orcid.org/0000-0003-4370-8271
![Sample our Bioscience journals, sign in here to start your access, Latest two full volumes FREE to you for 14 days]({"type":"image" , "src" : "/sda/5925/TOC-Subject-Sample-2021-Bioscience.jpg"})
Abstract
Aim: To develop a predictive model for ovarian failure (OF) after chemotherapy in young post-pubertal women with cancer. Methods: Retrospective, monocentric cohort study including 348 patients referring to the Oncofertility Unit of San Raffaele Hospital (Milan, Italy) from August 2011 to January 2020. A predictive model was constructed by multivariate logistic regression and receiver operating characteristic analysis. Results: Data about menstrual function resumption were available for 184 patients. The best predictive model for OF was identified by the combination of age; number of chemotherapy lines; vincristine, adriamycin, ifosphamide/adriamycin, ifosphamide; capecitabine; adriamycin, bleomycine, vinblastine, doxorubicin (area under the curve = 0.906; CI 95% 0.858–0.954; p = 0.0001). Conclusions: The model predicts the probability of loss of ovarian function at cancer diagnosis and with every change of treatment.
Plain language summary
Chemotherapy can reduce fertility in young women surviving cancer. The effects of chemotherapy on ovarian function range from no damage to several degrees of reduced fertility. In some cases, premature menopause can occur. This variability depends on many different individual and treatment-related factors. In this study, we analyzed the outcomes in terms of menses regularity and fertility of 348 oncological patients receiving counseling on fertility at our unit from August 2011 to January 2020. We developed a predictive model to estimate the risk of premature menopause of each patient, to be used at diagnosis and every time a new treatment must be started. This model includes a combination of patient's age, number of lines of chemotherapeutic treatment, and three chemotherapy schedules commonly used in young patients with cancer. It allows an improved counseling on fertility, and it can aid decision making regarding fertility preservation strategies for each patient.
Author contributions
R Cioffi's roles included conceptualization, data collection and analysis and manuscript drafting; A Bergamini, ML Fais and VS Vanni contributed to data collection and manuscript drafting; L Pagliardini contributed to statistical analysis; E Papaleo contributed to critical discussion of data and manuscript review; G Mangili contributed to study design, critical discussion of data and manuscript review; M Candiani contributed to critical discussion of data and manuscript review.
Disclaimer
The abstract for this work was discussed at the 22nd European Congress on Gynaecological Oncology (ESGO) 2021 (Prague, 25th October 2021), as oral presentation.
Financial & competing interests disclosure
A Bergamini reports receiving consulting fees from GSK, Pharmamar, Clovis Oncology and MSD/Astrazeneca and travel support from GSK and MSD/Astrazeneca. E Papaleo reports receving consulting fees from Gedeon Richter, MSD and Merck, grants from MSD, Ferring, Merck and Theramex and travel support from MSD, Ferring, Gedeon Richter, IBSA and Merck. G Mangili reports receiving consulting fees from AstraZeneca and Tesaro, lecture fees from Tesaro, and travel support from Roche Holding and Tesaro. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.
No writing assistance was utilized in the production of this manuscript.
Ethical conduct of research
The study was approved by the Institutional Review Board of San Raffaele Hospital (protocol Onco-fertility n. 284/11, 2015). All patients signed a written informed consent for the use of personal data. The authors state that they have obtained appropriate institutional review board approval or have followed the principles outlined in the Declaration of Helsinki for all human or animal experimental investigations. In addition, for investigations involving human subjects, informed consent has been obtained from the participants involved.