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Endocrine Toxicities of Antineoplastic Therapy. Cancers (Basel) 2021; 13:cancers13020294. [PMID: 33466843 PMCID: PMC7830439 DOI: 10.3390/cancers13020294] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 01/12/2021] [Indexed: 11/16/2022] Open
Abstract
In recent years, the prognosis of many solid tumors has improved markedly thanks to new treatment strategies, including tyrosine kinase inhibitors (TKIs) and immunotherapy [...].
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Safiyeh FD, Mojgan M, Parviz S, Sakineh MA, Behnaz SO. The effect of selenium and vitamin E supplementation on anti-Mullerian hormone and antral follicle count in infertile women with occult premature ovarian insufficiency: A randomized controlled clinical trial. Complement Ther Med 2020; 56:102533. [PMID: 33197657 DOI: 10.1016/j.ctim.2020.102533] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 07/24/2020] [Accepted: 07/27/2020] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE Increased accumulation of reactive oxygen species (ROS) in the process of oogenesis is one of the most well known causes of ovarian insufficiency and decreased ovarian reserve. Selenium and vitamin E as cofactors of glutathione peroxidase plays an important role in the removal of ROS in the ovary. We evaluated the effects of selenium and vitamin E supplementation on anti-Mullerian hormone (AMH) index and antral follicle count (AFC) (primary outcomes) and mean ovarian volume (MOV) and side effects of these supplements (secondary outcome) in infertile women with occult premature ovarian insufficiency (OPOI). METHODS 70 patients were allocated into the control and treatment groups through block randomization method. 35 women in the treatment group received 200 ng selenium and 400IU vitamin E and 35 women in the control group received placebo for a total of 90 days. AMH index, AFC and mean ovarian volume (MOV) were investigated in both groups after 12 months of study. RESULT There was no significant difference between groups before intervention in AMH (Mean difference: -0.08; 95% CI: -0.20 to.08; p=0.33), AFC (-0.71; 95%CI: -1.44 to -0.01; p=0.05) and MOV (-0.55; 95% CI: -0.85 to -0.24; p=0.001). There was a significant increase in AMH (mean difference: 0.59; 95% CI: 0.48 to 0.71; p<0.001), AFC (5.08; 95% CI: 4.36 to 5.08; p<0.001) and MOV (2.17; 95% CI: 1.87 to 2.47; p<0.001) in selenium + vitamin E group compared to placebo group 12 months after intervention. These supplements had no side effects. CONCLUSION Supplementation with selenium and vitamin E can increase AMH, AFC and MOV in women with OPOI.
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Affiliation(s)
- Farhadi Dizaji Safiyeh
- Department of midwifery, nursing and midwifery Faculty, Tabriz University of Medical sciences, Tabriz, Iran
| | - Mirghafourvand Mojgan
- Social Determinants of Health Research Center, Midwifery Department, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Shahabi Parviz
- Department of Physiology, Faculty of Medicine, Tabriz University of Medical sciences, Tabriz, Iran
| | - Mohammad Alizadeh Sakineh
- Department of midwifery, nursing and midwifery Faculty, Tabriz University of Medical sciences, Tabriz, Iran
| | - Sadeghzadeh Oskouei Behnaz
- Department of midwifery, nursing and midwifery Faculty, Tabriz University of Medical sciences, Tabriz, Iran.
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3
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Risk of chemotherapy-related amenorrhoea (CRA) in premenopausal women undergoing chemotherapy for early stage breast cancer. Breast Cancer Res Treat 2020; 186:237-245. [PMID: 33047206 PMCID: PMC7940159 DOI: 10.1007/s10549-020-05951-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 09/23/2020] [Indexed: 10/25/2022]
Abstract
PURPOSE While chemotherapy has improved survival among younger women with breast cancer, it can induce temporary or permanent chemotherapy-related amenorrhoea (CRA), impacting survival benefit, quality of life and, importantly for younger patients, fertility. METHODS This single institution retrospective study of 107 premenopausal women with early stage breast cancer who received neoadjuvant or adjuvant combined chemotherapy treatment investigates the association of clinicopathological factors (including age-related, gynaecological and tumour-related variables) with CRA and resumption of menses using generalised linear models for univariable and multivariate analyses. RESULTS 76% of women developed CRA, of which only 40% resumed menses after treatment. Age at time of treatment and at menarche were significantly associated with CRA incidence, with higher rates linked to older age (≥ 40 years) and later menarche (at ≥ 13 years), in both univariable (P = 0.043 and P = 0.009, respectively) and multivariate (P = 0.010 and P = 0.012, respectively) analyses. Age at time of treatment, age at menarche and use of tamoxifen were significantly associated with resumption of menses (with greater resumption rates linked to younger age (< 40 years old), later menarche (≥ 13 years old) or no tamoxifen use status), in both univariable (P < 0.0001, P = 0.002 and P = 0.039, respectively) and multivariate (P = 0.001, P = 0.011 and P = 0.008, respectively) analyses. Menses resumption rates were also significantly higher (P = 0.015) in women with later cessation of menses (after 3-6 chemotherapy cycles rather than sooner). CONCLUSIONS Age at menarche and, specially, at time of treatment are important risk factors for CRA. These variables could aid decision-making for treatment selection and fertility preservation among premenopausal women with early breast cancer.
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Shin JJ, Choi YM, Jun JK, Lee KH, Kim TY, Han W, Im SA. Amenorrhea and Menopause in Patients with Breast Cancer after Chemotherapy. J Breast Cancer 2019; 22:624-634. [PMID: 31897335 PMCID: PMC6933038 DOI: 10.4048/jbc.2019.22.e53] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Accepted: 11/03/2019] [Indexed: 12/19/2022] Open
Abstract
Purpose The probability of ovarian failure after cytotoxic chemotherapy in patients with breast cancer has not been well established in Korea. This study aimed to assess the rate of ovarian failure in a large cohort of Korean premenopausal patients with breast cancer 12 months after chemotherapy. Methods This retrospective cohort study included premenopausal women (aged 20−44 years) with breast cancer who underwent chemotherapy after surgery. The rates of treatment-related amenorrhea (TRA) and chemotherapy-induced menopause (CIM) at 12 months after chemotherapy were analyzed. Results A total of 237 patients met the inclusion criteria. The rate of TRA was 61.6% and that of CIM was 13.1% at 12 months after chemotherapy. The rates of TRA and CIM were 28.0% and 4.0%, respectively, in women aged 25−34 years, and they gradually increased up to 75.9% (TRA) and 15.8% (CIM), respectively, in women aged 40−44 years. The frequency of CIM was significantly lower than that of TRA in both age groups. In multivariate analyses, only tamoxifen use was significantly associated with a decreased risk of CIM (p < 0.001). Age of 40 years or higher and the regimens of doxorubicin plus cyclophosphamide followed by docetaxel or paclitaxel were associated with increased risk of TRA (p = 0.001 and p = 0.002, respectively). Conclusion Marked discrepancy in the rates of CIM and TRA was observed in this study. Further, the age-specific frequency of CIM and TRA observed in this study is a reliable and practical estimate of the risks of CIM and TRA in the absence of gonadal protection.
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Affiliation(s)
- Jae Jun Shin
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea.,Fertility Center, Heryoojae Women's Hospital, Goyang, Korea
| | - Young Min Choi
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea.,Medical Research Center, the Institute of Reproductive Medicine and Population, Seoul National University College of Medicine, Seoul, Korea
| | - Jong Kwan Jun
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea
| | - Kyung-Hun Lee
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.,Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Tae-Yong Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.,Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Wonshik Han
- Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.,Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Seock-Ah Im
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.,Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
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5
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Barrientos RM, Brunton PJ, Lenz KM, Pyter L, Spencer SJ. Neuroimmunology of the female brain across the lifespan: Plasticity to psychopathology. Brain Behav Immun 2019; 79:39-55. [PMID: 30872093 PMCID: PMC6591071 DOI: 10.1016/j.bbi.2019.03.010] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 02/25/2019] [Accepted: 03/09/2019] [Indexed: 02/06/2023] Open
Abstract
The female brain is highly dynamic and can fundamentally remodel throughout the normal ovarian cycle as well as in critical life stages including perinatal development, pregnancy and old-age. As such, females are particularly vulnerable to infections, psychological disorders, certain cancers, and cognitive impairments. We will present the latest evidence on the female brain; how it develops through the neonatal period; how it changes through the ovarian cycle in normal individuals; how it adapts to pregnancy and postpartum; how it responds to illness and disease, particularly cancer; and, finally, how it is shaped by old age. Throughout, we will highlight female vulnerability to and resilience against disease and dysfunction in the face of environmental challenges.
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Affiliation(s)
- R M Barrientos
- Institute for Behavioral Medicine Research, Wexner Medical Centre, The Ohio State University, Columbus, OH 43210, United States; Department of Psychiatry and Behavioral Health, Wexner Medical Centre, The Ohio State University, Columbus, OH 43210, United States; Chronic Brain Injury Program, Discovery Themes Initiative, The Ohio State University, Columbus, OH 43210, United States
| | - P J Brunton
- Centre for Discovery Brain Sciences, University of Edinburgh, Hugh Robson Building, George Square, Edinburgh EH8 9XD, Scotland, UK; Zhejiang University-University of Edinburgh Joint Institute, Zhejiang University School of Medicine, International Campus, Haining, Zhejiang 314400, PR China
| | - K M Lenz
- Institute for Behavioral Medicine Research, Wexner Medical Centre, The Ohio State University, Columbus, OH 43210, United States; Department of Psychology, Department of Neuroscience, The Ohio State University, Columbus, OH 43210, United States
| | - L Pyter
- Institute for Behavioral Medicine Research, Wexner Medical Centre, The Ohio State University, Columbus, OH 43210, United States; Department of Psychiatry and Behavioral Health, Wexner Medical Centre, The Ohio State University, Columbus, OH 43210, United States
| | - S J Spencer
- School of Health and Biomedical Sciences, RMIT University, Melbourne, Vic. 3083, Australia.
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6
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Adjuvant Endocrine Therapy for Breast Cancer. Breast Cancer 2019. [DOI: 10.1007/978-3-319-96947-3_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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7
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Frampton JE. Triptorelin: A Review of its Use as an Adjuvant Anticancer Therapy in Early Breast Cancer. Drugs 2018; 77:2037-2048. [PMID: 29177573 DOI: 10.1007/s40265-017-0849-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
A 1-month formulation of the gonadotrophin-releasing hormone agonist (GnRHa) triptorelin (Decapeptyl®) has been approved in the EU as an adjuvant treatment in combination with tamoxifen or an aromatase inhibitor (AI), of endocrine-responsive, early-stage breast cancer in women at high risk of recurrence who are confirmed as premenopausal after completion of chemotherapy. This indication reflects the results of the 5-year SOFT and TEXT studies, especially SOFT, in which ovarian function suppression (OFS; mainly achieved with triptorelin) added to tamoxifen provided a significant benefit in the overall study population of premenopausal patients only after adjusting for prognostic factors. It emerged that adding OFS to tamoxifen produced more pronounced benefits in terms of disease control and, furthermore, increased overall survival in the cohort of higher-risk patients who had previously received chemotherapy. Also, compared with tamoxifen alone, the combination of OFS plus exemestane produced more pronounced benefits in terms of disease control than OFS plus tamoxifen. OFS induces premature menopause; when combined with either tamoxifen or exemestane, it increased the endocrine symptom burden. Nonetheless, the two combinations had distinct tolerability profiles (e.g. vasomotor symptoms and thromboembolic events were more frequent with OFS plus tamoxifen, whereas musculoskeletal symptoms, decreased libido, osteoporosis and fractures were more frequent with OFS plus exemestane). Thus, the combinations of OFS (with triptorelin) plus either tamoxifen or an AI are valid options for the adjuvant treatment of endocrine-responsive, early-stage breast cancer in women at sufficiently high risk of relapse to warrant receiving chemotherapy and who remain premenopausal thereafter. Individualized weighing of the potential benefits and adverse effects of treatment is required.
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Affiliation(s)
- James E Frampton
- Springer, Private Bag 65901, Mairangi Bay, Auckland 0754, New Zealand.
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8
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Mathis KM, Sturgeon KM, Winkels RM, Wiskemann J, Williams NI, Schmitz K. Exercise and chemotherapy-induced amenorrhea. Med Hypotheses 2018; 116:49-53. [DOI: 10.1016/j.mehy.2018.04.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 03/27/2018] [Accepted: 04/24/2018] [Indexed: 11/26/2022]
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Cronin-Fenton DP, Kjærsgaard A, Ahern TP, Mele M, Ewertz M, Hamilton-Dutoit S, Christiansen PM, Ejlertsen B, Sørensen HT, Lash TL, Silliman RA. Validity of Danish Breast Cancer Group (DBCG) registry data used in the predictors of breast cancer recurrence (ProBeCaRe) premenopausal breast cancer cohort study. Acta Oncol 2017; 56:1155-1160. [PMID: 28585885 DOI: 10.1080/0284186x.2017.1327720] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Validation studies of the Danish Breast Cancer Group (DBCG) registry show good agreement with medical records for adjuvant treatment data, but inconsistent recurrence information. No studies have validated changes in menopausal status or endocrine therapy during follow-up. In a longitudinal study, we validated DBCG data using medical records as the gold standard. MATERIAL AND METHODS From a cohort of 5959 premenopausal women diagnosed during 2002-2010 with stage I-III breast cancer, we selected 151 patients - 77 estrogen-receptor-positive and 74 estrogen-receptor-negative - from three hospitals. We assessed the validity of DBCG registry data on patient, tumor, and treatment factors, and follow-up information on menopausal transition, changes in endocrine therapy, and recurrence. We computed positive predictive values (PPVs) with 95% confidence intervals (95%CI). RESULTS Agreement was near perfect for tumor size, lymph node involvement, receptor status, surgery type, and receipt of radiotherapy, chemotherapy, or tamoxifen treatment. The PPV for a change in endocrine therapy in the DBCG was 96% (95%CI = 83, 100). The PPV for menopausal transition was 61% (95%CI = 42, 77). The PPV for DBCG-recorded recurrence was 100%. However, of 19 patients who had a recurrence documented in their medical record, 13 had the recurrence registered in DBCG. CONCLUSIONS DBCG data are valid for most epidemiological studies of breast cancer treatment. Data on menopausal transition may be less valid, though this interpretation depends on the suitability of medical records for making this assessment. Although recurrence is missing for some, this would not bias most ratio measures of association.
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Affiliation(s)
| | - Anders Kjærsgaard
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | - Thomas P. Ahern
- The Robert Larner, M.D. College of Medicine at The University of Vermont, Burlington, VT, USA
| | - Marco Mele
- Breast Unit, Surgical Department, Randers Regional Hospital, Randers, Denmark
| | - Marianne Ewertz
- Department of Oncology, Odense University Hospital, Odense, Denmark
- Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
| | | | - Peer M. Christiansen
- Breast Unit, Surgical Department, Randers Regional Hospital, Randers, Denmark
- Department of Plastic and Breast Surgery, Aarhus University Hospital, Aarhus, Denmark
- Danish Breast Cancer Cooperative Group, Copenhagen, Denmark
| | - Bent Ejlertsen
- Danish Breast Cancer Cooperative Group, Copenhagen, Denmark
- Rigshospitalet, Copenhagen, Denmark
| | - Henrik T. Sørensen
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
- Department of Health Research & Policy (Epidemiology), Stanford University, Stanford, CA, USA
| | - Timothy L. Lash
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Rebecca A. Silliman
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
- Boston University School of Medicine, Boston University, Boston, MA, USA
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Regressions of Breast Carcinoma Syngraft Following Treatment with Piperine in Combination with Thymoquinone. Sci Pharm 2017; 85:scipharm85030027. [PMID: 28671634 PMCID: PMC5620515 DOI: 10.3390/scipharm85030027] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Revised: 06/26/2017] [Accepted: 06/27/2017] [Indexed: 12/13/2022] Open
Abstract
Thymoquinone (TQ) and piperine, the active ingredients in cumin (Nigella sativa) and black pepper (Piper longum), respectively, exhibit various bioactivities including anticancer effects. The aim of the present study is to investigate the antineoplastic activity of a combination of TQ and piperine against breast cancer implanted in mice. The antiproliferative effects of TQ, piperine, and a combination of both agents were tested against mouse epithelial breast cancer cell line (EMT6/P) using MTT assay. The isobolographic method was used to calculate the combination index (CI). Degree of angiogenesis inhibition was detected by measuring vascular endothelial growth factor (VEGF) levels in tissue culture for all treatments. EMT6/P cells were inoculated in Balb/C mice and the antitumor effect of TQ, piperine, and their combination was assessed. Changes in tumor size were calculated for all treatments. Tumor histology was examined using the hematoxylin/eosin staining protocol. Terminal deoxynucleotidyl transferase (TdT) dUTP Nick-End Labeling (TUNEL) colorimetric assay and caspase-3 activity assays were used to detect apoptosis. Serum levels of interferon (INF)-γ, interleukin (IL)-4, IL-2, and IL-10 were measured using ELISA and treatment toxicity was evaluated by measuring serum levels of aspartate transaminase (AST), alanine transaminase (ALT), and creatinine. A clear synergistic antiproliferative interaction between TQ and piperine was observed with CI value of 0.788. The combination therapy resulted in significant reduction in tumor size with percentage cure of 60% and percentage death of 0%. High degrees of apoptosis and geographical necrosis were induced in tumors treated with the combination therapy. Combination therapy caused significant decrease in VEGF expression and increased serum INF-γ levels. Normal serum levels of AST, ALT, and creatinine were observed in tumor-bearing mice treated with the combination therapy. The combination of TQ and piperine acts synergistically to target breast cancer in vitro and in vivo. This novel combination exerts its effect by angiogenesis inhibition, apoptosis induction, and shifting the immune response toward T helper1 response. This combination therapy deserves further investigation (including measurement of hypoxia-inducible factor (HIF)1α to be used in clinical studies.
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11
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Visser K, Zierau O, Macejová D, Goerl F, Muders M, Baretton GB, Vollmer G, Louw A. The phytoestrogenic Cyclopia extract, SM6Met, increases median tumor free survival and reduces tumor mass and volume in chemically induced rat mammary gland carcinogenesis. J Steroid Biochem Mol Biol 2016; 163:129-35. [PMID: 27142456 DOI: 10.1016/j.jsbmb.2016.04.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Revised: 04/28/2016] [Accepted: 04/29/2016] [Indexed: 02/07/2023]
Abstract
SM6Met, a phytoestrogenic extract of Cyclopia subternata indigenous to the Western Cape province of South Africa, displays estrogenic attributes with potential for breast cancer chemoprevention. In this study, we report that SM6Met, in the presence of estradiol, induces a significant cell cycle G0/G1 phase arrest similar to the selective estrogen receptor modulator, tamoxifen. Furthermore, as a proof of concept, in the N-Methyl-N-nitrosourea induced rat mammary gland carcinogenesis model, SM6Met increases tumor latency by 7days and median tumor free survival by 42 days, while decreasing palpable tumor frequency by 32%, tumor mass by 40%, and tumor volume by 53%. Therefore, the current study provides proof of concept that SM6Met has definite potential as a chemopreventative agent against the development and progression of breast cancer.
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MESH Headings
- Animals
- Antineoplastic Agents, Phytogenic/isolation & purification
- Antineoplastic Agents, Phytogenic/pharmacology
- Cell Line, Tumor
- Cyclopia Plant/chemistry
- Estrogen Antagonists/pharmacology
- Female
- G1 Phase Cell Cycle Checkpoints/drug effects
- G1 Phase Cell Cycle Checkpoints/genetics
- Humans
- Mammary Glands, Animal/drug effects
- Mammary Glands, Animal/metabolism
- Mammary Glands, Animal/pathology
- Mammary Neoplasms, Experimental/chemically induced
- Mammary Neoplasms, Experimental/drug therapy
- Mammary Neoplasms, Experimental/mortality
- Mammary Neoplasms, Experimental/pathology
- Methylnitrosourea
- Phytoestrogens/isolation & purification
- Phytoestrogens/pharmacology
- Rats
- Receptors, Estrogen/antagonists & inhibitors
- Receptors, Estrogen/genetics
- Receptors, Estrogen/metabolism
- Survival Analysis
- Tamoxifen/pharmacology
- Tumor Burden/drug effects
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Affiliation(s)
- Koch Visser
- Biochemistry Department, Stellenbosch University, Stellenbosch, Western Cape, South Africa
| | - Oliver Zierau
- Molecular Cell Physiology and Endocrinology, Institute for Zoology, Technische Universität Dresden, Dresden, Germany
| | - Dana Macejová
- Institute of Experimental Endocrinology, Slovak Academy of Sciences, Bratislava, Slovak Republic
| | - Florian Goerl
- Institute for Pathology, Radeberg, Germany; Institute for Pathology, University Clinic Carl-Gustav-Carus, Dresden, Germany
| | - Michael Muders
- Institute for Pathology, University Clinic Carl-Gustav-Carus, Dresden, Germany
| | - Gustavo B Baretton
- Institute for Pathology, University Clinic Carl-Gustav-Carus, Dresden, Germany
| | - Günter Vollmer
- Molecular Cell Physiology and Endocrinology, Institute for Zoology, Technische Universität Dresden, Dresden, Germany
| | - Ann Louw
- Biochemistry Department, Stellenbosch University, Stellenbosch, Western Cape, South Africa.
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12
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Barnabei A, Strigari L, Marchetti P, Sini V, De Vecchis L, Corsello SM, Torino F. Predicting Ovarian Activity in Women Affected by Early Breast Cancer: A Meta-Analysis-Based Nomogram. Oncologist 2015; 20:1111-8. [PMID: 26341758 DOI: 10.1634/theoncologist.2015-0183] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2015] [Accepted: 06/25/2015] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The assessment of ovarian reserve in premenopausal women requiring anticancer gonadotoxic therapy can help clinicians address some challenging issues, including the probability of future pregnancies after the end of treatment. Anti-Müllerian hormone (AMH) and age can reliably estimate ovarian reserve. A limited number of studies have evaluated AMH and age as predictors of residual ovarian reserve following cytotoxic chemotherapy in breast cancer patients. MATERIALS AND METHODS To conduct a meta-analysis of published data on this topic, we searched the medical literature using the key MeSH terms "amenorrhea/chemically induced," "ovarian reserve," "anti-Mullerian hormone/blood," and "breast neoplasms/drug therapy." Preferred Reporting Items for Systematic Reviews and Meta-Analyses statements guided the search strategy. U.K. National Health Service guidelines were used in abstracting data and assessing data quality and validity. Area under the receiver operating characteristic curve (ROC/AUC) analysis was used to evaluate the predictive utility of baseline AMH and age model. RESULTS The meta-analysis of data pooled from the selected studies showed that both age and serum AMH are reliable predictors of post-treatment ovarian activity in breast cancer patients. Importantly, ROC/AUC analysis indicated AMH was a more reliable predictor of post-treatment ovarian activity in patients aged younger than 40 years (0.753; 95% confidence interval [CI]: 0.602-0.904) compared with those older than 40 years (0.678; 95% CI: 0.491-0.866). We generated a nomogram describing the correlations among age, pretreatment AMH serum levels, and ovarian activity at 1 year from the end of chemotherapy. CONCLUSION After the ongoing validation process, the proposed nomogram may help clinicians discern premenopausal women requiring cytotoxic chemotherapy who should be considered high priority for fertility preservation counseling and procedures.
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Affiliation(s)
- Agnese Barnabei
- Endocrinology Unit, "Regina Elena" National Cancer Institute of Rome, Rome, Italy
| | - Lidia Strigari
- Laboratory of Medical Physics and Expert Systems, "Regina Elena" National Cancer Institute of Rome, Rome, Italy
| | - Paolo Marchetti
- Department of Clinical and Molecular Medicine, Medical Oncology Division, "Sapienza" University of Rome, Rome, Italy Sant'Andrea Hospital, Rome, Italy IDI-IRCCS, Rome, Italy
| | - Valentina Sini
- Department of Clinical and Molecular Medicine, Medical Oncology Division, "Sapienza" University of Rome, Rome, Italy Oncology Unit, "Santo Spirito" Hospital - Lungotevere in Sassia, Rome, Italy
| | - Liana De Vecchis
- Department of Systems Medicine, "Tor Vergata" University of Rome, Rome, Italy
| | | | - Francesco Torino
- Department of Systems Medicine, "Tor Vergata" University of Rome, Rome, Italy
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13
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HIMOTO Y, KIDO A, FUJIMOTO K, DAIDO S, KIGUCHI K, SHITANO F, BABA T, MATSUMURA N, KONISHI I, TOGASHI K. MR Imaging-based Evaluation of Morphological Changes in the Uterus and Ovaries of Patients Following Neoadjuvant Chemotherapy for Cervical Cancer. Magn Reson Med Sci 2015; 14:65-72. [DOI: 10.2463/mrms.2014-0025] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- Yuki HIMOTO
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University
| | - Aki KIDO
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University
| | - Koji FUJIMOTO
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University
| | - Sayaka DAIDO
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University
| | - Kayo KIGUCHI
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University
| | - Fuki SHITANO
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University
| | - Tsukasa BABA
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University
| | - Noriomi MATSUMURA
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University
| | - Ikuo KONISHI
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University
| | - Kaori TOGASHI
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University
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Eivazi-Ziaei J, Asvadi I, Esfahani A, Vaez J, Pourzand A, Shabanloei R, Sattari MR. Chemotherapy-induced amenorrhea in patients suffering from breast cancer in the Northwest of Iran. South Asian J Cancer 2014; 3:233-4. [PMID: 25422816 PMCID: PMC4236708 DOI: 10.4103/2278-330x.143041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Jamal Eivazi-Ziaei
- Breast Cancer Study Group, Hematology and Oncology Research Center, Tabriz, Department of Internal Medicine, University of Medical Sciences, Tabriz, Iran
| | - I Asvadi
- Breast Cancer Study Group, Hematology and Oncology Research Center, Tabriz, Department of Internal Medicine, University of Medical Sciences, Tabriz, Iran
| | - A Esfahani
- Breast Cancer Study Group, Hematology and Oncology Research Center, Tabriz, Department of Internal Medicine, University of Medical Sciences, Tabriz, Iran
| | - J Vaez
- Breast Cancer Study Group, Hematology and Oncology Research Center, Tabriz, Department of Internal Medicine, University of Medical Sciences, Tabriz, Iran
| | - A Pourzand
- Breast Cancer Study Group, Hematology and Oncology Research Center, Tabriz, Department of Internal Medicine, University of Medical Sciences, Tabriz, Iran
| | - R Shabanloei
- Breast Cancer Study Group, Hematology and Oncology Research Center, Tabriz, Department of Internal Medicine, University of Medical Sciences, Tabriz, Iran
| | - M R Sattari
- Breast Cancer Study Group, Hematology and Oncology Research Center, Tabriz, Department of Internal Medicine, University of Medical Sciences, Tabriz, Iran
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Yalamanchi S, Dobs A, Greenblatt RM. Gonadal function and reproductive health in women with human immunodeficiency virus infection. Endocrinol Metab Clin North Am 2014; 43:731-41. [PMID: 25169564 PMCID: PMC4151241 DOI: 10.1016/j.ecl.2014.05.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Most human immunodeficiency virus (HIV) infections among women occur early in reproductive life, which highlights the importance of understanding the impact of HIV on reproductive functions, and also the potential implications of reproductive function and aging on the course of HIV disease. Ovarian function is a crucial component of reproductive biology in women, but standard assessment methods are of limited applicability to women with chronic diseases such as HIV. Pregnancy can now be achieved without transmission of HIV to sexual partner or newborn, but complications of pregnancy may be more common in women infected with HIV than uninfected women.
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Affiliation(s)
- Swaytha Yalamanchi
- Department of Endocrinology, Diabetes and Metabolism, Johns Hopkins University School of Medicine, 1830 Monument Street, Baltimore, MD 21287, USA
| | - Adrian Dobs
- Department of Endocrinology, Diabetes and Metabolism, Johns Hopkins University School of Medicine, 1830 Monument Street, Baltimore, MD 21287, USA
| | - Ruth M Greenblatt
- Department of Clinical Pharmacy, University of California, San Francisco Schools of Pharmacy and Medicine, 405 Irving Street, Second Floor, San Francisco, CA 94122, USA; Department of Medicine, University of California, San Francisco Schools of Pharmacy and Medicine, 405 Irving Street, Second Floor, San Francisco, CA 94122, USA; Department of Epidemiology and Biostatistics, University of California, San Francisco Schools of Pharmacy and Medicine, 405 Irving Street, Second Floor, San Francisco, CA 94122, USA.
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16
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Lopes F, Smith R, Anderson RA, Spears N. Docetaxel induces moderate ovarian toxicity in mice, primarily affecting granulosa cells of early growing follicles. Mol Hum Reprod 2014; 20:948-59. [PMID: 25080441 PMCID: PMC4172173 DOI: 10.1093/molehr/gau057] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Advances in cancer therapy have focused attention on the quality of life of cancer survivors. Since infertility is a major concern following chemotherapy, it is important to characterize the drug-specific damage to the reproductive system to help find appropriate protective strategies. This study investigates the damage on neonatal mouse ovary maintained in vitro for 6 days, and exposed for 24 h (on Day 2) to clinically relevant doses of Docetaxel (DOC; low: 0.1 µM, mid: 1 µM, high: 10 µM). Furthermore, the study explores the putative protective action exerted by Tri-iodothyronine (T3; 10−7 M). At the end of culture, morphological analyses and follicle counts showed that DOC negatively impacts on early growing follicles, decreasing primary follicle number and severely affecting health at the transitional and primary stages. Poor follicle health was mainly due to effects on granulosa cells, indicating that the effects of DOC on oocytes were likely to be secondary to granulosa cell damage. DOC damages growing follicles specifically, with no direct effect on the primordial follicle reserve. Immunostaining and western blotting showed that DOC induces activation of intrinsic, type II apoptosis in ovarian somatic cells; increasing the levels of cleaved caspase 3, cleaved caspase 8, Bax and cleaved poly(ADP-ribose) polymerase, while also inducing movement of cytochrome C from mitochondria into the cytosol. T3 did not prevent the damage induced by the low dose of DOC. These results demonstrated that DOC induces a gonadotoxic effect on the mouse ovary through induction of somatic cell apoptosis, with no evidence of direct effects on the oocyte, and that the damaging effect is not mitigated by T3.
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Affiliation(s)
- Federica Lopes
- Centre for Integrative Physiology, University of Edinburgh, Edinburgh EH8 9XD, UK
| | - Rowena Smith
- Centre for Integrative Physiology, University of Edinburgh, Edinburgh EH8 9XD, UK
| | - Richard A Anderson
- MRC Centre for Reproductive Health, University of Edinburgh, Edinburgh EH16 4TJ, UK
| | - Norah Spears
- Centre for Integrative Physiology, University of Edinburgh, Edinburgh EH8 9XD, UK
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17
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Adjuvant Endocrine Therapy of Perimenopausal and Recently Postmenopausal Women With Hormone Receptor-Positive Breast Cancer. Clin Breast Cancer 2014; 14:147-53. [DOI: 10.1016/j.clbc.2013.12.010] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2013] [Accepted: 12/12/2013] [Indexed: 11/21/2022]
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Abstract
The study of large prospective collections of plasma samples from women prior to the development of breast cancer has firmly established certain sex steroids as being significantly associated with risk. The strongest associations have been found in postmenopausal women in whom the within person variability of most hormones is markedly reduced but some positive associations have also been seen in premenopausal women. Plasma estrogens show the strongest correlations with risk and these are strengthened by measurement or calculation of the proportion of estradiol that circulates free of sex hormone binding globulin (SHBG), consistent with this being the most active fraction. The relationships have been reported to potentially explain virtually all of the association of breast cancer with body mass index in postmenopausal women; this is likely to be due to non-ovarian estrogen synthesis being prominent in subcutaneous fat. These strong relationships have led to plasma and urine estrogen levels being used as intermediate end-points in the search for genes that affect breast cancer risk via their role in steroid disposition. Plasma androgen levels also show a relationship with breast cancer risk that is weakened but not eliminated by 'correction' for estrogen levels. This has been argued to be evidence of the local production of estrogens being important in the etiology of breast cancer. Given that plasma steroid levels do not correlate closely with mammographic density, which is strongly associated with risk, the opportunity exists to combine the two factors in assessing breast cancer risk but the low availability of suitable estrogen assays is a major impediment to this. In established breast cancer, plasma estrogens have been found to correlate with gene expression of estrogen dependent genes and the expression of these varies across the menstrual cycle of premenopausal women. There is infrequently a need for routine measurement of plasma estrogen levels but it has been important in the comparative pharmacology and dose-related effectiveness of aromatase inhibitors. Measurement may be needed to identify residual ovarian function in women who have amenorrhea subsequent to cytotoxic chemotherapy indicating their unsuitability for aromatase inhibitor treatment. Use of highly sensitive assays has also revealed that the association between BMI and plasma estrogen levels persists in patients on 3rd generation aromatase inhibitors and that measurable increments in plasma estrogen levels occur with some vaginal estrogen preparations that are of concern in relation to treatment efficacy.
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Affiliation(s)
- Elizabeth Folkerd
- The Academic Department of Biochemistry, The Royal Marsden NHS Foundation Trust, Wallace Wing, Fulham Road, London SW3 6JJ, UK.
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19
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Abstract
With increasing use of screening mammography and more effective adjuvant systemic therapies, the majority of women diagnosed with early stage breast cancer will be long-term survivors and experience personal cures. Among the common side effects of adjuvant therapies is treatment-related bone loss, primarily as a result of estrogen deprivation. Whereas this occurs in both postmenopausal and premenopausal women, this brief review will focus on pre- or perimenopausal women when initially diagnosed with breast cancer. An important distinction is between those women who retain ovarian function despite cancer or preventative treatments and the more common situation of premenopausal women who as result of cancer treatments undergo ovarian failure or early menopause. Some women with treatment-related ovarian failure will have sufficient treatment-related bone loss to be at increased risks of subsequent nontraumatic fractures and/or osteoporosis and will be candidates for antiresorptive treatments. The noncancer treatment risk factors, screening and treatments for the management of osteopenia and osteoporosis are generally the same in postmenopausal women with and without breast cancer. However, premenopausal women with relatively rapid onset of treatment-related ovarian failure and bone loss pose several challenges. Awareness of treatment-related bone loss and risks of subsequent osteoporosis is a high priority in an ever-increasing population of breast cancer survivors.
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Affiliation(s)
- Loomee Doo
- Wexner College of Medicine, The Ohio State University, Columbus, OH, USA
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20
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Valentini A, Finch A, Lubiński J, Byrski T, Ghadirian P, Kim-Sing C, Lynch HT, Ainsworth PJ, Neuhausen SL, Greenblatt E, Singer C, Sun P, Narod SA. Chemotherapy-induced amenorrhea in patients with breast cancer with a BRCA1 or BRCA2 mutation. J Clin Oncol 2013; 31:3914-9. [PMID: 23980083 PMCID: PMC3805929 DOI: 10.1200/jco.2012.47.7893] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE To determine the likelihood of long-term amenorrhea after treatment with chemotherapy in women with breast cancer who carry a BRCA1 or BRCA2 mutation. PATIENTS AND METHODS We conducted a multicenter survey of 1,954 young women with a BRCA1 or BRCA2 mutation who were treated for breast cancer. We included premenopausal women who were diagnosed with invasive breast cancer between 26 and 47 years of age. We determined the age of onset of amenorrhea after breast cancer for women who were and were not treated with chemotherapy, alone or with tamoxifen. We considered chemotherapy-induced amenorrhea to have occurred when the patient experienced ≥ 2 years of amenorrhea, commencing within 2 years of initiating chemotherapy, with no resumption of menses. RESULTS Of the 1,426 women who received chemotherapy, 35% experienced long-term amenorrhea. Of the 528 women who did not receive chemotherapy, 5.3% developed long-term amenorrhea. The probabilities of chemotherapy-induced amenorrhea were 7.2% for women diagnosed before age 30 years, 33% for women age 31 to 44 years, and 79% for women diagnosed after age 45 years (P trend < .001). The probability of induced amenorrhea was higher for women who received tamoxifen than for those who did not (52% v 29%; P < .001). CONCLUSION Age at treatment and use of tamoxifen are important predictors of chemotherapy-induced amenorrhea in women who carry a BRCA1 or BRCA2 mutation. The risk of induced long-term amenorrhea does not seem to be greater among mutation carriers than among women who do not carry a mutation.
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Affiliation(s)
- Adriana Valentini
- Adriana Valentini, Amy Finch, Ping Sun, and Steven A. Narod, Women's College Research Institute; Ellen Greenblatt, Centre for Fertility and Reproductive Health, Mount Sinai Hospital, University of Toronto, Toronto; Peter J. Ainsworth, London Regional Cancer Program, London, Ontario; Parviz Ghadirian, Research Center of the University of Montreal Hospital Centre, Montreal, Quebec; Charmaine Kim-Sing, BC Cancer Agency, Vancouver, British Columbia, Canada; Henry T. Lynch, Creighton University School of Medicine, Omaha, NE; Susan L. Neuhausen, Beckman Research Institute, City of Hope, Duarte, CA; Jan Lubiński and Tomasz Byrski, Hereditary Cancer Center, Pomeranian Medical University, Szczecin, Poland; and Christian Singer, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Amy Finch
- Adriana Valentini, Amy Finch, Ping Sun, and Steven A. Narod, Women's College Research Institute; Ellen Greenblatt, Centre for Fertility and Reproductive Health, Mount Sinai Hospital, University of Toronto, Toronto; Peter J. Ainsworth, London Regional Cancer Program, London, Ontario; Parviz Ghadirian, Research Center of the University of Montreal Hospital Centre, Montreal, Quebec; Charmaine Kim-Sing, BC Cancer Agency, Vancouver, British Columbia, Canada; Henry T. Lynch, Creighton University School of Medicine, Omaha, NE; Susan L. Neuhausen, Beckman Research Institute, City of Hope, Duarte, CA; Jan Lubiński and Tomasz Byrski, Hereditary Cancer Center, Pomeranian Medical University, Szczecin, Poland; and Christian Singer, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Jan Lubiński
- Adriana Valentini, Amy Finch, Ping Sun, and Steven A. Narod, Women's College Research Institute; Ellen Greenblatt, Centre for Fertility and Reproductive Health, Mount Sinai Hospital, University of Toronto, Toronto; Peter J. Ainsworth, London Regional Cancer Program, London, Ontario; Parviz Ghadirian, Research Center of the University of Montreal Hospital Centre, Montreal, Quebec; Charmaine Kim-Sing, BC Cancer Agency, Vancouver, British Columbia, Canada; Henry T. Lynch, Creighton University School of Medicine, Omaha, NE; Susan L. Neuhausen, Beckman Research Institute, City of Hope, Duarte, CA; Jan Lubiński and Tomasz Byrski, Hereditary Cancer Center, Pomeranian Medical University, Szczecin, Poland; and Christian Singer, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Tomasz Byrski
- Adriana Valentini, Amy Finch, Ping Sun, and Steven A. Narod, Women's College Research Institute; Ellen Greenblatt, Centre for Fertility and Reproductive Health, Mount Sinai Hospital, University of Toronto, Toronto; Peter J. Ainsworth, London Regional Cancer Program, London, Ontario; Parviz Ghadirian, Research Center of the University of Montreal Hospital Centre, Montreal, Quebec; Charmaine Kim-Sing, BC Cancer Agency, Vancouver, British Columbia, Canada; Henry T. Lynch, Creighton University School of Medicine, Omaha, NE; Susan L. Neuhausen, Beckman Research Institute, City of Hope, Duarte, CA; Jan Lubiński and Tomasz Byrski, Hereditary Cancer Center, Pomeranian Medical University, Szczecin, Poland; and Christian Singer, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Parviz Ghadirian
- Adriana Valentini, Amy Finch, Ping Sun, and Steven A. Narod, Women's College Research Institute; Ellen Greenblatt, Centre for Fertility and Reproductive Health, Mount Sinai Hospital, University of Toronto, Toronto; Peter J. Ainsworth, London Regional Cancer Program, London, Ontario; Parviz Ghadirian, Research Center of the University of Montreal Hospital Centre, Montreal, Quebec; Charmaine Kim-Sing, BC Cancer Agency, Vancouver, British Columbia, Canada; Henry T. Lynch, Creighton University School of Medicine, Omaha, NE; Susan L. Neuhausen, Beckman Research Institute, City of Hope, Duarte, CA; Jan Lubiński and Tomasz Byrski, Hereditary Cancer Center, Pomeranian Medical University, Szczecin, Poland; and Christian Singer, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Charmaine Kim-Sing
- Adriana Valentini, Amy Finch, Ping Sun, and Steven A. Narod, Women's College Research Institute; Ellen Greenblatt, Centre for Fertility and Reproductive Health, Mount Sinai Hospital, University of Toronto, Toronto; Peter J. Ainsworth, London Regional Cancer Program, London, Ontario; Parviz Ghadirian, Research Center of the University of Montreal Hospital Centre, Montreal, Quebec; Charmaine Kim-Sing, BC Cancer Agency, Vancouver, British Columbia, Canada; Henry T. Lynch, Creighton University School of Medicine, Omaha, NE; Susan L. Neuhausen, Beckman Research Institute, City of Hope, Duarte, CA; Jan Lubiński and Tomasz Byrski, Hereditary Cancer Center, Pomeranian Medical University, Szczecin, Poland; and Christian Singer, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Henry T. Lynch
- Adriana Valentini, Amy Finch, Ping Sun, and Steven A. Narod, Women's College Research Institute; Ellen Greenblatt, Centre for Fertility and Reproductive Health, Mount Sinai Hospital, University of Toronto, Toronto; Peter J. Ainsworth, London Regional Cancer Program, London, Ontario; Parviz Ghadirian, Research Center of the University of Montreal Hospital Centre, Montreal, Quebec; Charmaine Kim-Sing, BC Cancer Agency, Vancouver, British Columbia, Canada; Henry T. Lynch, Creighton University School of Medicine, Omaha, NE; Susan L. Neuhausen, Beckman Research Institute, City of Hope, Duarte, CA; Jan Lubiński and Tomasz Byrski, Hereditary Cancer Center, Pomeranian Medical University, Szczecin, Poland; and Christian Singer, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Peter J. Ainsworth
- Adriana Valentini, Amy Finch, Ping Sun, and Steven A. Narod, Women's College Research Institute; Ellen Greenblatt, Centre for Fertility and Reproductive Health, Mount Sinai Hospital, University of Toronto, Toronto; Peter J. Ainsworth, London Regional Cancer Program, London, Ontario; Parviz Ghadirian, Research Center of the University of Montreal Hospital Centre, Montreal, Quebec; Charmaine Kim-Sing, BC Cancer Agency, Vancouver, British Columbia, Canada; Henry T. Lynch, Creighton University School of Medicine, Omaha, NE; Susan L. Neuhausen, Beckman Research Institute, City of Hope, Duarte, CA; Jan Lubiński and Tomasz Byrski, Hereditary Cancer Center, Pomeranian Medical University, Szczecin, Poland; and Christian Singer, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Susan L. Neuhausen
- Adriana Valentini, Amy Finch, Ping Sun, and Steven A. Narod, Women's College Research Institute; Ellen Greenblatt, Centre for Fertility and Reproductive Health, Mount Sinai Hospital, University of Toronto, Toronto; Peter J. Ainsworth, London Regional Cancer Program, London, Ontario; Parviz Ghadirian, Research Center of the University of Montreal Hospital Centre, Montreal, Quebec; Charmaine Kim-Sing, BC Cancer Agency, Vancouver, British Columbia, Canada; Henry T. Lynch, Creighton University School of Medicine, Omaha, NE; Susan L. Neuhausen, Beckman Research Institute, City of Hope, Duarte, CA; Jan Lubiński and Tomasz Byrski, Hereditary Cancer Center, Pomeranian Medical University, Szczecin, Poland; and Christian Singer, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Ellen Greenblatt
- Adriana Valentini, Amy Finch, Ping Sun, and Steven A. Narod, Women's College Research Institute; Ellen Greenblatt, Centre for Fertility and Reproductive Health, Mount Sinai Hospital, University of Toronto, Toronto; Peter J. Ainsworth, London Regional Cancer Program, London, Ontario; Parviz Ghadirian, Research Center of the University of Montreal Hospital Centre, Montreal, Quebec; Charmaine Kim-Sing, BC Cancer Agency, Vancouver, British Columbia, Canada; Henry T. Lynch, Creighton University School of Medicine, Omaha, NE; Susan L. Neuhausen, Beckman Research Institute, City of Hope, Duarte, CA; Jan Lubiński and Tomasz Byrski, Hereditary Cancer Center, Pomeranian Medical University, Szczecin, Poland; and Christian Singer, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Christian Singer
- Adriana Valentini, Amy Finch, Ping Sun, and Steven A. Narod, Women's College Research Institute; Ellen Greenblatt, Centre for Fertility and Reproductive Health, Mount Sinai Hospital, University of Toronto, Toronto; Peter J. Ainsworth, London Regional Cancer Program, London, Ontario; Parviz Ghadirian, Research Center of the University of Montreal Hospital Centre, Montreal, Quebec; Charmaine Kim-Sing, BC Cancer Agency, Vancouver, British Columbia, Canada; Henry T. Lynch, Creighton University School of Medicine, Omaha, NE; Susan L. Neuhausen, Beckman Research Institute, City of Hope, Duarte, CA; Jan Lubiński and Tomasz Byrski, Hereditary Cancer Center, Pomeranian Medical University, Szczecin, Poland; and Christian Singer, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Ping Sun
- Adriana Valentini, Amy Finch, Ping Sun, and Steven A. Narod, Women's College Research Institute; Ellen Greenblatt, Centre for Fertility and Reproductive Health, Mount Sinai Hospital, University of Toronto, Toronto; Peter J. Ainsworth, London Regional Cancer Program, London, Ontario; Parviz Ghadirian, Research Center of the University of Montreal Hospital Centre, Montreal, Quebec; Charmaine Kim-Sing, BC Cancer Agency, Vancouver, British Columbia, Canada; Henry T. Lynch, Creighton University School of Medicine, Omaha, NE; Susan L. Neuhausen, Beckman Research Institute, City of Hope, Duarte, CA; Jan Lubiński and Tomasz Byrski, Hereditary Cancer Center, Pomeranian Medical University, Szczecin, Poland; and Christian Singer, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Steven A. Narod
- Adriana Valentini, Amy Finch, Ping Sun, and Steven A. Narod, Women's College Research Institute; Ellen Greenblatt, Centre for Fertility and Reproductive Health, Mount Sinai Hospital, University of Toronto, Toronto; Peter J. Ainsworth, London Regional Cancer Program, London, Ontario; Parviz Ghadirian, Research Center of the University of Montreal Hospital Centre, Montreal, Quebec; Charmaine Kim-Sing, BC Cancer Agency, Vancouver, British Columbia, Canada; Henry T. Lynch, Creighton University School of Medicine, Omaha, NE; Susan L. Neuhausen, Beckman Research Institute, City of Hope, Duarte, CA; Jan Lubiński and Tomasz Byrski, Hereditary Cancer Center, Pomeranian Medical University, Szczecin, Poland; and Christian Singer, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
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Cardoso F, Bese N, Distelhorst SR, Bevilacqua JLB, Ginsburg O, Grunberg SM, Gralla RJ, Steyn A, Pagani O, Partridge AH, Knaul FM, Aapro MS, Andersen BL, Thompson B, Gralow JR, Anderson BO. Supportive care during treatment for breast cancer: resource allocations in low- and middle-income countries. A Breast Health Global Initiative 2013 consensus statement. Breast 2013; 22:593-605. [PMID: 24001709 PMCID: PMC7442957 DOI: 10.1016/j.breast.2013.07.050] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2013] [Accepted: 07/23/2013] [Indexed: 12/20/2022] Open
Abstract
Breast cancer patients may have unmet supportive care needs during treatment, including symptom management of treatment-related toxicities, and educational, psychosocial, and spiritual needs. Delivery of supportive care is often a low priority in low- and middle-income settings, and is also dependent on resources available. This consensus statement describes twelve key recommendations for supportive care during treatment in low- and middle-income countries, identified by an expert international panel as part of the 5th Breast Health Global Initiative (BHGI) Global Summit for Supportive Care, which was held in October 2012, in Vienna, Austria. Panel recommendations are presented in a 4-tier resource-stratified table to illustrate how health systems can provide supportive care services during treatment to breast cancer patients, starting at a basic level of resource allocation and incrementally adding program resources as they become available. These recommendations include: health professional and patient and family education; management of treatment related toxicities, management of treatment-related symptoms of fatigue, insomnia and non-specific pain, and management of psychosocial and spiritual issues related to breast cancer treatment. Establishing supportive care during breast cancer treatment will help ensure that breast cancer patients receive comprehensive care that can help 1) improve adherence to treatment recommendations, 2) manage treatment-related toxicities and other treatment related symptoms, and 3) address the psychosocial and spiritual aspects of breast cancer and breast cancer treatments.
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Affiliation(s)
| | - Nuran Bese
- Acibadem Maslak Hospital Breast Health, Istanbul, Turkey
| | | | | | - Ophira Ginsburg
- Women’s College Research Institute, Faculty of Medicine, Dalla Lana School of Public Health, University of Toronto, Canada
| | - Steven M. Grunberg
- Multinational Association of Supportive Care in Cancer, Shelburne, Vermont, USA
| | | | - Ann Steyn
- Reach to Recovery International; Reach to Recovery South Africa, Cape Town. South Africa
| | - Olivia Pagani
- European School of Oncology and Institute of Oncology of Southern Switzerland, Viganello, Switzerland
| | | | - Felicia Marie Knaul
- Harvard Global Equity Initiative, Boston, Massachusetts, USA; Tómatelo a Pecho A.C., Mexico City, Mexico
| | | | | | - Beti Thompson
- Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Julie R. Gralow
- Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
- Seattle Cancer Care Alliance, University of Washington, Seattle, Washington, USA
| | - Benjamin O. Anderson
- Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
- Seattle Cancer Care Alliance, University of Washington, Seattle, Washington, USA
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22
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Ganz PA, Yip CH, Gralow JR, Distelhorst SR, Albain KS, Andersen BL, Bevilacqua JLB, de Azambuja E, El Saghir NS, Kaur R, McTiernan A, Partridge AH, Rowland JH, Singh-Carlson S, Vargo MM, Thompson B, Anderson BO. Supportive care after curative treatment for breast cancer (survivorship care): Resource allocations in low- and middle-income countries. A Breast Health Global Initiative 2013 consensus statement. Breast 2013; 22:606-15. [DOI: 10.1016/j.breast.2013.07.049] [Citation(s) in RCA: 71] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2013] [Accepted: 07/23/2013] [Indexed: 12/31/2022] Open
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23
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Torino F, Barnabei A, De Vecchis L, Sini V, Schittulli F, Marchetti P, Corsello SM. Chemotherapy-induced ovarian toxicity in patients affected by endocrine-responsive early breast cancer. Crit Rev Oncol Hematol 2013; 89:27-42. [PMID: 23953684 DOI: 10.1016/j.critrevonc.2013.07.007] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2013] [Revised: 06/16/2013] [Accepted: 07/18/2013] [Indexed: 11/30/2022] Open
Abstract
Cytotoxic chemotherapy may variably affect ovarian function depending on age and ovarian reserve at diagnosis, type of chemotherapy and use of tamoxifen. Ascertaining whether a premenopausal patient with endocrine-responsive early breast cancer and chemotherapy-induced amenorrhea has reached menopause is essential not only in order to provide accurate information on residual fertility, but also to appropriately prescribe endocrine therapy. Indeed, aromatase inhibitors are contraindicated in women with residual ovarian reserve. However, the diagnosis of menopause in patients with chemotherapy-induced amenorrhea is challenging, since clinical features, follicle-stimulating hormone and estradiol levels may be inaccurate to this aim. Recent studies demonstrated that the anti-müllerian hormone may improve the assessment of ovarian reserve residual to chemotherapy in women with early breast cancer. Herein, we review the incidence of amenorrhea and menopause induced by cytotoxic chemotherapy in women affected by early breast cancer and the suggested mechanisms that sustain these side-effects. Furthermore, it has been scrutinized the potential of new markers of ovarian reserve that may facilitate the selection of appropriate endocrine treatment for premenopausal women who develop amenorrhea following adjuvant chemotherapy for early breast cancer.
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Affiliation(s)
- Francesco Torino
- Department of Systems Medicine, Chair of Medical Oncology, Tor Vergata University of Rome, Italy
| | - Agnese Barnabei
- Endocrinology Unit, Regina Elena National Cancer Institute, Rome, Italy
| | - Liana De Vecchis
- Department of Systems Medicine, Chair of Medical Oncology, Tor Vergata University of Rome, Italy
| | - Valentina Sini
- Surgical and Medical Department of Clinical Sciences, Biomedical Technologies and Translational Medicine, "Sapienza" University of Rome, Italy
| | | | - Paolo Marchetti
- Department of Clinical and Molecular Medicine, Medical Oncology Division, Sant'Andrea Hospital, "Sapienza" University of Rome and IDI-IRCCS, Rome, Italy
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Christinat A, Di Lascio S, Pagani O. Hormonal therapies in young breast cancer patients: when, what and for how long? J Thorac Dis 2013; 5 Suppl 1:S36-46. [PMID: 23819026 DOI: 10.3978/j.issn.2072-1439.2013.05.25] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2013] [Accepted: 05/19/2013] [Indexed: 12/26/2022]
Abstract
Breast cancer in young women (<40 years) is a rare and complex clinical and psychosocial condition, which deserves multidisciplinary and personalized approaches. In young women with hormone-receptor positive disease, 5 years of adjuvant tamoxifen, with or without ovarian suppression/ablation, is considered the standard endocrine therapy. The definitive role of adjuvant aromatase inhibitors has still to be elucidated: the upcoming results of the Tamoxifen and EXemestane Trial (TEXT) and Suppression of Ovarian Function Trial (SOFT) trials will help understanding if we can widen our current endocrine therapeutic options. The optimal duration of adjuvant endocrine therapy in young women also remains an unresolved issue. The recently reported results of the ATLAS and aTToM trials represent the first evidence of a beneficial effect of extended endocrine therapy in premenopausal women and provide an important opportunity in high-risk young patients. In the metastatic setting, endocrine therapy should be the preferred choice for endocrine responsive disease, unless there is evidence of endocrine resistance or need for rapid disease and/or symptom control. Tamoxifen in combination with ovarian suppression/ablation remains the 1st-line endocrine therapy of choice. Aromatase inhibitors in combination with ovarian suppression/ablation can be considered after progression on tamoxifen and ovarian suppression/ablation. Fulvestrant has not yet been studied in pre-menopausal women. Specific age-related treatment side effects (i.e., menopausal symptoms, change in body image and weight gain, cognitive function impairment, fertility damage/preservation, long-term organ dysfunction, sexuality) and the social impact of diagnosis and treatment (i.e., job discrimination, family management) should be carefully addressed when planning long-lasting endocrine therapies in young women with hormone-receptor positive early and advanced breast cancer.
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Affiliation(s)
- Alexandre Christinat
- Institute of Oncology of Southern Switzerland (IOSI) and Breast Unit of Southern Switzerland (CSSI), Bellinzona, Switzerland
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Role of mesenchymal stem cell therapy in restoring ovarian function in a rat model of chemotherapy-induced ovarian failure. ACTA ACUST UNITED AC 2013. [DOI: 10.1097/01.ehx.0000423979.18253.10] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Buwalda B, Schagen SB. Is basic research providing answers if adjuvant anti-estrogen treatment of breast cancer can induce cognitive impairment? Life Sci 2013; 93:581-8. [PMID: 23353876 DOI: 10.1016/j.lfs.2012.12.012] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2012] [Revised: 11/27/2012] [Accepted: 12/21/2012] [Indexed: 12/23/2022]
Abstract
Adjuvant treatment of cancer by chemotherapy is associated with cognitive impairment in some cancer survivors. Breast cancer patients are frequently also receiving endocrine therapy with selective estrogen receptor modulators (SERMs) and/or aromatase inhibitors (AIs) to suppress the growth of estradiol sensitive breast tumors. Estrogens are well-known, however, to target brain areas involved in the regulation of cognitive behavior. In this review clinical and basic preclinical research is reviewed on the actions of estradiol, SERMs and AIs on brain and cognitive functioning to see if endocrine therapy potentially induces cognitive impairment and in that respect may contribute to the detrimental effects of chemotherapy on cognitive performance in breast cancer patients. Although many clinical studies may be underpowered to detect changes in cognitive function, current basic and clinical reports suggest that there is little evidence that AIs may have a lasting detrimental effect on cognitive performance in breast cancer patients. The clinical data on SERMs are not conclusive, but some studies do suggest that tamoxifen administration may form a risk for cognitive functioning particularly in older women. An explanation may come from basic preclinical research which indicates that tamoxifen often acts agonistic in the absence of estradiol but antagonistic in the presence of endogenous estradiol. It could be hypothesized that the negative effects of tamoxifen in older women is related to the so-called window of opportunity for estrogen. Administration of SERMs beyond this so-called window of opportunity may not be effective or might even have detrimental effects similar to estradiol.
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Affiliation(s)
- Bauke Buwalda
- Behavioral Physiology, University of Groningen, Nijenborgh 7, 9747 AG Groningen, The Netherlands.
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