全身治疗对早期乳腺癌女性生育能力的影响。
Impact of Systemic Therapy on Fertility in Women with Early-Stage Breast Cancer.
作者信息
Natsuhara Kelsey H, Chien A Jo
机构信息
Division of Hematology & Oncology, Department of Medicine, University of California San Francisco, 1825 4th St, San Francisco, CA 94158, USA.
出版信息
Curr Breast Cancer Rep. 2024 Mar;16(1):61-68. doi: 10.1007/s12609-023-00516-z. Epub 2024 Jan 3.
PURPOSE OF REVIEW
Fertility concerns are common among young women diagnosed with breast cancer, as systemic therapy increases the risk of premature ovarian insufficiency and delays family planning. Here, we review the impact of systemic therapies, including chemotherapy, endocrine therapy, HER-2 directed therapy, PARP inhibitors, and immunotherapy, on ovarian reserve.
RECENT FINDINGS
With an improved understanding of disease biology, fewer women are treated with gonadotoxic chemotherapy. There are limited data on the fertility impact of novel targeted treatments and immunotherapy, though preclinical and preliminary studies suggest an impact on fertility is possible. Notably, a recent study investigated the outcomes in women who interrupted adjuvant endocrine therapy to attempt pregnancy.
SUMMARY
Further research is needed to characterize the fertility impact of novel therapies in breast cancer. Individualized fertility counseling should be offered to all women to discuss the possible impact of therapy on ovarian reserve and options for fertility preservation and timing of pregnancy.
综述目的
生育问题在被诊断为乳腺癌的年轻女性中很常见，因为全身治疗会增加卵巢早衰的风险并延迟计划生育。在此，我们综述全身治疗，包括化疗、内分泌治疗、HER-2靶向治疗、PARP抑制剂和免疫治疗，对卵巢储备的影响。
最新发现
随着对疾病生物学的认识不断提高，接受性腺毒性化疗的女性减少。关于新型靶向治疗和免疫治疗对生育的影响的数据有限，尽管临床前和初步研究表明可能对生育有影响。值得注意的是，最近一项研究调查了中断辅助内分泌治疗以尝试怀孕的女性的结局。
总结
需要进一步研究以明确新型疗法对乳腺癌生育的影响。应向所有女性提供个性化的生育咨询，以讨论治疗对卵巢储备的可能影响以及生育力保存和怀孕时机的选择。
Zotero 插件