Gonadotropin‐releasing hormone agonists for ovarian protection during cancer chemotherapy: systematic review and meta‐analysis

Abstract

ABSTRACT

Ovarian protection with gonadotropin-releasing hormone agonists during chemotherapy in cancer patients: From biological evidence to clinical application

“…However, notably, the trials were not designed nor powered to assess differences in post-treatment pregnancies, pregnancy desire was not a criteria for study inclusion and most of the trials reported results at a short follow-up time without the possibility of assessing this important outcome. Although the numbers remain low, all the most recent meta-analyses reported a significantly higher number of post-treatment pregnancies in breast cancer patients who received GnRHa during chemotherapy as compared to those treated with systemic cytotoxic therapy alone [114,115,117,118,120], with no benefit in lymphoma patients [118].…”

“…Several meta-analyses have been conducted to summarize the results from the available randomized trials performed to investigate the clinical efficacy of temporary ovarian suppression with GnRHa during chemotherapy in premenopausal cancer patients (Table 6) [101][102][103][104][105][106][107][108][109][110][111][112][113][114][115][116][117][118][119][120]. The oldest meta-analyses included also prospective non-randomized studies, some were restricted to a single tumor type (i.e.…”

Current practices in menstrual management in adolescents with cancer: A national survey of pediatric oncology providers

“…Adult literature has had mixed results on the efficacy GnRH agonists for gonadal protection and prevention of ovarian failure . A recent systematic review and meta‐analysis found that GnRH agonists had a benefit in patients with breast cancer, but not for lymphoma patients . Given that providers indicate that a primary reason for using GnRH agonists was potential gonadal protection, there are limited data that this will be protective in AYAs with cancer, additional provider education regarding the use of GnRH agonists may be beneficial.…”

“…[36][37][38][39][40] A recent systematic review and meta-analysis found that GnRH agonists had a benefit in patients with breast cancer, but not for lymphoma patients. 41 Given that providers indicate that a primary reason for using GnRH agonists was potential gonadal protection, there are limited data that this will be protective in AYAs with cancer, additional provider education regarding the use of GnRH agonists may be beneficial. Additionally, investigation should be done to better understand how providers counsel patients regarding GnRH agonists as well at patients' perceptions of GnRH utilization and gonadal protection.…”

Pharmacological correction of pathological changes in the viable offspring of rats, caused by cytostatic impact at the stage of progenesis

“…В связи с этим важным является вопрос о сохранении овариального резерва после цитостатической терапии. В клинической практике существует такая возможность, для этого используются гонадотропинрилизинг-гормоны, уменьшающие количество клеток мишеней (делящихся клеток) путем остановки функции яичников [8]. Однако это только одна сторона решения проблемы, которая стоит в тесной связи с другой -необходимостью снижения риска генетических нарушений, вызываемых цитостатиками в созревающих ооцитах.…”