Evaluating the impacts of emerging cancer therapies on ovarian function. (June 2021)

• Record Type: Journal Article
• Authors: Alesi, Lauren R.; Winship, Amy L.; Hutt, Karla J.
• Is Part Of: Current opinion in endocrine and metabolic research. Volume 18(2021)
• Page Start: 15
• Page End: 28
• Publication Date: 2021-06
• Subjects: Oncofertility -- Fertility preservation -- Chemotherapy -- Small-molecule inhibitors -- Immunotherapy -- Immune checkpoint inhibitors; AMH anti-Müllerian hormone -- bFGF basic fibroblast growth factor -- CAR chimeric antigen receptor -- CDK cyclin-dependent kinase -- CHK checkpoint kinase -- CTLA-4 cytotoxic T lymphocyte–associated protein 4 -- EGF epidermal growth factor -- EGFR epidermal growth factor receptor -- FDA US Food and Drug Administration -- FSH follicle-stimulating hormone -- GM-CSF granulocyte–macrophage colony-stimulating factor -- GnRH gonadotropin-releasing hormone -- IFN interferon -- INK4 inhibitors of CDK4 -- IL interleukin -- LH luteinising hormone -- NK natural killer cell -- PAR poly(ADP-ribose) -- PARP poly(ADP-ribose) polymerase -- PDGF platelet-derived growth factor -- PDGFR platelet-derived growth factor receptor -- PD-1 programmed cell death protein 1 -- PD-L1 programmed death-ligand 1 -- STAT3 signal transducer and activator of transcription 3 -- TCR T-cell receptor -- TGF transforming growth factor -- TLR Toll-like receptor -- TNF tumour necrosis factor -- Treg regulatory T lymphocyte -- VEGF vascular endothelial growth factor -- VEGFR vascular endothelial growth factor receptor; Endocrine glands -- Diseases -- Periodicals; Metabolism -- Disorders -- Periodicals; Endocrine System Diseases; Metabolic Diseases; Endocrine glands -- Diseases; Metabolism -- Disorders; Periodical; Electronic journals; Periodicals; Electronic journals; 616.4
• DOI: 10.1016/j.coemr.2020.12.004
• Languages: English
• ISSNs: 2451-9650

Abstract

Abstract: Ovarian damage, resulting in oocyte death, loss of endocrine function and infertility, is a well-documented side effect of many traditional, cytotoxic cancer therapies. However, the landscape of cancer therapies is rapidly changing. Women are now also receiving new treatments, such as small-molecule inhibitors and immunotherapies, but little is known about the potential consequences of these drug classes for the ovary and reproductive health. This lack of knowledge is because ovarian function and fertility end points are often not included in clinical trials of cancer treatments, and fertility studies on women can take years or decades to complete. Thus, studies defining the impacts of new treatments on the ovary using animal models should be prioritised. Providing patients and clinicians with evidence regarding the potential impacts on future fertility is vital for them to make informed treatment decisions. Here, we critically evaluate the potential for emerging treatments, including small-molecule inhibitors and immunotherapies, to interfere with ovarian function and fertility. We draw on knowledge of ovarian biology and the drug mechanism of action to highlight the potential mechanisms of ovarian damage. Highlights: The landscape of cancer therapies is rapidly changing. Traditional, cytotoxic cancer therapies can have detrimental effects on ovarian function and impair long-term fertility. Emerging therapies such as biologicals and small-molecule inhibitors are already part of clinical oncological care. However, there is no knowledge of the consequences of these therapies on reproductive health. This creates new challenges for oncologists and fertility specialists counselling patients. These concerns must be addressed.