Fertility Preservation and Assisted Reproduction in Patients With Breast Cancer Interrupting Adjuvant Endocrine Therapy to Attempt Pregnancy-Reference-Cited by-同舟云学术

Fertility Preservation and Assisted Reproduction in Patients With Breast Cancer Interrupting Adjuvant Endocrine Therapy to Attempt Pregnancy

Published:2024-08-10 Issue:23 Volume:42 Page:2822-2832
ISSN:0732-183X
Container-title:Journal of Clinical Oncology
language:en
Short-container-title:JCO

Author:

Azim Hatem A.¹²^ORCID,Niman Samuel M.³⁴,Partridge Ann H.⁵⁶^ORCID,Demeestere Isabelle⁷⁸^ORCID,Ruggeri Monica⁹,Colleoni Marco¹⁰^ORCID,Saura Cristina¹¹¹²^ORCID,Shimizu Chikako¹³^ORCID,Saetersdal Anna B.¹⁴,Kroep Judith R.¹⁵¹⁶^ORCID,Mailliez Audrey¹⁷^ORCID,Warner Ellen¹⁸¹⁹,Borges Virginia F.²⁰^ORCID,Amant Frédéric²¹²²²³^ORCID,Gombos Andrea²⁴,Kataoka Akemi²⁵^ORCID,Rousset-Jablonski Christine²⁶^ORCID,Borstnar Simona²⁷,Takei Junko²⁸^ORCID,Lee Jeong Eon²⁹³⁰^ORCID,Walshe Janice M.³¹³²³³^ORCID,Ruíz-Borrego Manuel³⁴³⁵^ORCID,Moore Halle C.F.³⁶^ORCID,Saunders Christobel³⁷³⁸^ORCID,Bjelic-Radisic Vesna³⁹⁴⁰⁴¹,Susnjar Snezana⁴²^ORCID,Cardoso Fatima⁴³^ORCID,Klar Natalie J.⁴⁴^ORCID,Spanic Tanja⁴⁵,Ruddy Kathryn⁴⁶^ORCID,Piccart Martine²⁴^ORCID,Korde Larissa A.⁴⁷,Goldhirsch Aron⁴⁸⁴⁹^ORCID,Gelber Richard D.³⁴⁶⁵⁰⁵¹^ORCID,Pagani Olivia⁵²⁵³⁵⁴,Peccatori Fedro A.⁵⁵^ORCID

Affiliation:

1. Cairo Cure Oncology Center, Cairo, Egypt

2. Breast Cancer Center, Hospital Zambrano Hellion, School of Medicine, Tecnologico de Monterrey, San Pedro Garza Garcia, Mexico

3. International Breast Cancer Study Group Statistical Center, Boston, MA

4. Department of Data Science, Division of Biostatistics, Dana-Farber Cancer Institute, Boston, MA

5. Medical Oncology, Dana-Farber Cancer Institute, Boston, MA

6. Harvard Medical School, Boston, MA

7. Research Laboratory on Human Reproduction, Université Libre de Bruxelles (ULB), Brussels, Belgium

8. Gynecology and Obstetrics Department, Fertility Clinic, HUB-Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium

9. Program for Young Patients, International Breast Cancer Study Group, A Division of ETOP IBCSG Partners Foundation, Bern, Switzerland

10. Division of Medical Senology, IEO, European Institute of Oncology, IRCCS, Milan, Italy

11. Vall d’Hebron University Hospital, Vall d’Hebron Institute of Oncology, Barcelona, Spain

12. SOLTI Breast Cancer Research Group, Barcelona, Spain

13. Department of Breast and Medical Oncology, National Center for Global Health and Medicine, Tokyo, Japan

14. Breast Cancer Unit, Department of Oncology, Division of Cancer Medicine, Oslo University Hospital, Oslo, Norway

15. Department of Medical Oncology, Leiden University Medical Center, Leiden, the Netherlands

16. Dutch Breast Cancer Research Group (BOOG), Amsterdam, the Netherlands

17. Breast Cancer Unit, Department of Medical Oncology, Centre Oscar Lambret, Lille, France

18. Odette Cancer Center, Sunnybrook Health Sciences Center, Toronto, ON, Canada

19. Canadian Clinical Trials Group (CCTG), Toronto, ON, Canada

20. Division of Medical Oncology, Department of Medicine, University of Colorado Cancer Center, Aurora, CO

21. Department of Oncology, KU Leuven and Leuven Cancer Institute, Leuven, Belgium

22. Department of Obstetrics and Gynecology, University Hospitals Leuven, Leuven, Belgium

23. Antoni van Leeuwenhoek-Netherlands Gynecologic Oncology Cancer Institute, Amsterdam, the Netherlands

24. Institut Jules Bordet and Université Libre de Bruxelles, Brussels, Belgium

25. Breast Oncology Cancer, The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan

26. Department of Surgery, Leon Berard Cancer Centre, Centre Léon Bérard, Lyon, France

27. Division of Medical Oncology, Institute of Oncology, Ljubljana, Slovenia

28. St Luke's International Hospital, Breast Center, Tokyo, Japan

29. Breast Division, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea

30. Department of Clinical Research and Evaluation, SAIHST, Sungkyunkwan University, Seoul, South Korea

31. Cancer Trials Ireland, Dublin, Ireland

32. Department of Medical Oncology, St Vincent's University Hospital, Dublin, Ireland

33. Tallaght University Hospital, Dublin, Ireland

34. GEICAM Spanish Breast Cancer Group, Madrid, Spain

35. Hospital Virgen del Rocio Sevilla, Sevilla, Spain

36. Breast Oncology Program, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH

37. Department of Surgery, University of Melbourne, Melbourne, VIC, Australia

38. Royal Melbourne Hospital, Melbourne, VIC, Australia

39. Breast Unit, Helios University Hospital Wuppertal, University Witten/Herdecke, Wuppertal, Germany

40. Medical University Graz, Department Gynaecology, Graz, Austria

41. Austrian Breast and Colorectal Study Group (ABCSG), Vienna, Austria

42. Department of Medical Oncology, Institute for Oncology and Radiology of Serbia, Belgrade, Serbia

43. Breast Unit, Champalimaud Clinical Center/Champalimaud Foundation, Lisbon, Portugal

44. New York University Langone's Perlmutter Cancer Center, Breast Cancer Center, New York, NY

45. Europa Donna, Ljubljana, Slovenia

46. Department of Oncology, Mayo Clinic, Rochester, MN

47. Breast and Melanoma Therapeutics, Cancer Therapy Evaluation Program, National Cancer Institute, Bethesda, MD

48. International Breast Cancer Study Group, Division of ETOP IBCSG Partners Foundation, Bern, Switzerland

49. IEO, European Institute of Oncology, IRCCS, Milan, Italy

50. Frontier Science Foundation, Boston, MA

51. Harvard TH Chan School of Public Health, Boston, MA

52. Geneva University Hospitals, Geneva, Switzerland

53. Lugano University, Lugano, Switzerland

54. Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland

55. Fertility and Procreation Unit, Gynecologic Oncology Program, IEO, European Institute of Oncology IRCCS, Milan, Italy

Abstract

PURPOSE We investigated time to pregnancy, efficacy and safety of fertility preservation, and assisted reproductive technologies (ARTs) in women with early hormone receptor–positive breast cancer (BC) desiring future pregnancy. PATIENTS AND METHODS POSITIVE is an international, single-arm, prospective trial, in which 518 women temporarily interrupted adjuvant endocrine therapy to attempt pregnancy. We evaluated menstruation recovery and factors associated with time to pregnancy and investigated if ART use was associated with achieving pregnancy. The cumulative incidence of BC-free interval (BCFI) events was estimated according to the use of ovarian stimulation at diagnosis. The median follow-up was 41 months. RESULTS Two hundred seventy-three patients (53%) reported amenorrhea at enrollment, of whom 94% resumed menses within 12 months. Among 497 patients evaluable for pregnancy, 368 (74%) reported at least one pregnancy. Young age was the main factor associated with shorter time to pregnancy with cumulative incidences of pregnancy by 1 year of 63.5%, 54.3%, and 37.7% for patients age <35, 35-39, and 40-42 years, respectively. One hundred and seventy-nine patients (36%) had embryo/oocyte cryopreservation at diagnosis, of whom 68 reported embryo transfer after enrollment. Cryopreserved embryo transfer was the only ART associated with higher chance of pregnancy (odds ratio, 2.41 [95% CI, 1.75 to 4.95]). The cumulative incidence of BCFI events at 3 years was similar for women who underwent ovarian stimulation for cryopreservation at diagnosis, 9.7% (95% CI, 6.0 to 15.4), compared with those who did not, 8.7% (95% CI, 6.0 to 12.5). CONCLUSION In POSITIVE, fertility preservation using ovarian stimulation was not associated with short-term detrimental impact on cancer prognosis. Pregnancy rates were highest among those who underwent embryo/oocyte cryopreservation followed by embryo transfer.

Publisher

American Society of Clinical Oncology (ASCO)

Link

https://ascopubs.org/doi/pdfdirect/10.1200/JCO.23.02292

Reference22 articles.

1. Prognostic Impact of Pregnancy After Breast Cancer According to Estrogen Receptor Status: A Multicenter Retrospective Study

2. Survival after breast cancer in women with a subsequent live birth: Influence of age at diagnosis and interval to subsequent pregnancy

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4. Knowledge of age-related fertility decline in women: A systematic review

5. Interrupting Endocrine Therapy to Attempt Pregnancy after Breast Cancer

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