Long-Acting Luteinizing Hormone-Releasing Hormone Agonist for Ovarian Hyperstimulation Induced by Tamoxifen for Breast Cancer

Kojima, Nobue; Yamasaki, Yui; Koh, Houu; Miyashita, Masaru; Morita, Hiroki

doi:10.1155/2018/4931852

Cited by 4 publications

(4 citation statements)

References 19 publications

(24 reference statements)

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“…Ovarian hyperstimulation, ovarian cyst, and supraphysiological estradiol levels due to the use of tamoxifen for breast cancer have been reported in 11-17% of the cases (12,13). In a study, the prevalence of ovarian cysts in patients using tamoxifen has been reported as 19.4% in premenopausal and 6.3% in postmenopausal women (14).…”

Section: Discussionmentioning

confidence: 99%

Leuprolide Acetate Treatment for Ovarian Cysts in Breast Cancer Patients Under Tamoxifen Therapy

Baran

Durdağ²,

Alemdaroğlu³

et al. 2022

Gynecol Obstet Reprod Med

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OBJECTIVE: The aim of this study is to evaluate the outcomes of gonadotropin-releasing hormone agonist treatment for ovarian cysts, which are developed during tamoxifen use due to breast cancer. STUDY DESIGN: This was a retrospective cohort study including the patients who were under tamoxifen treatment due to stage I-III breast cancer and who were administered leuprolide acetate for ovarian cysts with low malignancy risk between 2012-2020. RESULTS: Leuprolide acetate was administered to a total of 16 patients with ovarian cysts. The median age was 39.5 (33-52), the median size of the ovarian cyst was 42.5 (39-79) mm, and the median duration of tamoxifen use was 22 (7-36) months. Leuprolide acetate was administered at doses of 3.75 mg for 1 month at 10 (62.5%) patients, 7.5 mg in two months at 3 (18.75%) patients, and 11.25 mg in three months at 3 (18.75%) patients. Ovarian cysts were regressed after treatment at 13 patients, while 3 patients underwent surgery. CONCLUSION: Leuprolide acetate can be used as an option in the treatment of ovarian cysts that develop in breast cancer patients under tamoxifen therapy. Keywords: Breast neoplasms, Gonadotropin-releasing hormone, Ovary, Ovarian cyst, Tamoxifen

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Section: Discussionmentioning

confidence: 99%

Leuprolide Acetate Treatment for Ovarian Cysts in Breast Cancer Patients Under Tamoxifen Therapy

Baran

Durdağ²,

Alemdaroğlu³

et al. 2022

Gynecol Obstet Reprod Med

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“…6b) [13,14]. Although recent reports also pointed out the stimulatory effects TAM on the ovarian function [16,17], its precise incidence rate remains unclear. The positive rate of OHS among groups A-C (25.1%) was slightly higher than the ratio estimated in our previous report [14].…”

Section: Discussionmentioning

confidence: 99%

Ovarian hyperstimulation closely associated with resumption of follicular growth after chemotherapy during tamoxifen treatment in premenopausal women with breast cancer: a multicenter retrospective cohort study

et al. 2020

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Background: We previously reported that tamoxifen (TAM)-induced ovarian hyperstimulation (OHS) is associated with high serum concentrations of estradiol in premenopausal women with breast cancer. To investigate risk factors for TAM-induced OHS, we performed a retrospective multicenter study. Methods: Premenopausal patients who received surgical therapy for endocrine-dependent breast cancer (n = 235) were recruited in this study and classified into 4 groups: group A, treated with TAM alone; group B, TAM treatment after 2-year-combined therapy with a gonadotropin-releasing hormone (Gn-RH) agonist; group C, TAM treatment after chemotherapy; group D, 5-year-combined therapy with TAM and a Gn-RH agonist. A serum estradiol value of more than 300 pg/mL or mean follicular diameter of more than 30 mm was defined as OHS. Results: The incidence of OHS in group A (n = 13/26, 50.0%) was significantly higher than those in group B (n = 17/ 63, 27.0%), group C (n = 20/110, 18.2%), and group D (n = 0/36, 0%). The incidence of OHS was significantly correlated with aging, and the median serum concentration of estradiol in the presence of OHS was 823.0 pg/mL. The incidence of OHS (less than 47 years old) was 62.5% in group A, 48.6% in group B, and 28.2% in group C, respectively. Notably, the incidence rate of OHS following amenorrhea in group C (n = 13/20, 65.0%) was significantly higher than that in group B (n = 1/17, 5.9%). Conclusions: These findings indicate that the onset of OHS following amenorrhea was common in the postchemotherapeutic group, while its ratio was low in the group after Gn-RH analog treatment, suggesting that combined treatment-based management involving TAM therapy is necessary for premenopausal patients with breast cancer.

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“…In the uterus, TAM has rare adverse effects such as endometrial carcinoma and uterine sarcoma related to estrogenic properties [7]. In addition, an increased risk of ovarian hyperstimulation, the development of ovarian cysts and supraphysiological levels of serum E2 were reported in TAM-treated women with breast cancer [8][9][10]. During the follicular phase, TAM was suggested to inhibit E2 negative feedback on the hypothalamicpituitary axis, leading to increased pituitary secretion of FSH and LH and the development of multiple follicles.…”

Section: Introductionmentioning

confidence: 99%

Molecular Action of Tamoxifen in the Ovaries of Rats with Mammary Neoplasia

Nynca,

Swigonska,

Molcan

et al. 2023

IJMS

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Tamoxifen (TAM) is a drug commonly used in patients with breast cancer. The anticancer effect of TAM occurs via its ability to antagonize estrogen-dependent growth of mammary epithelial cells. Previously, we demonstrated that TAM prevented the chemotherapy-induced loss of ovarian follicular reserves in both cancer-free rats and rats with cancer. Such follicular loss is a main cause of infertility in young women treated for cancer. The current study was undertaken to discover the molecules and intracellular pathways involved in the action of TAM in the ovaries of rats with mammary tumors. To meet this goal we used transcriptomic (RNA-Seq) and proteomic (2D-DIGE/MS) approaches. TAM inhibited the expression of genes and lncRNAs involved in ovarian steroidogenesis. Moreover, TAM altered the expression of genes related to primordial follicle activation or arrest. In addition, proteomic screening indicated the importance of basic metabolic processes in the ovarian actions of TAM. Although simple extrapolation of these data to humans is not possible, the results of this study emphasize the need to explore the ability of TAM to affect ovarian function in women undergoing cancer treatment.

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Long-Acting Luteinizing Hormone-Releasing Hormone Agonist for Ovarian Hyperstimulation Induced by Tamoxifen for Breast Cancer

Cited by 4 publications

References 19 publications

Leuprolide Acetate Treatment for Ovarian Cysts in Breast Cancer Patients Under Tamoxifen Therapy

Leuprolide Acetate Treatment for Ovarian Cysts in Breast Cancer Patients Under Tamoxifen Therapy

Ovarian hyperstimulation closely associated with resumption of follicular growth after chemotherapy during tamoxifen treatment in premenopausal women with breast cancer: a multicenter retrospective cohort study

Molecular Action of Tamoxifen in the Ovaries of Rats with Mammary Neoplasia

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