Ovarian function following targeted anti-angiogenic therapy with bevacizumab

Abstract

Abstract. Improvements in cancer therapy have enabled further insight into the long-term effects of treatment, including the highly prevalent gonadal failure. The focus of treatment has been shifted to the preservation of fertility, which may be achieved by preventing ovarian toxicity. To this end, new molecular-targeted agents, including monoclonal antibodies, have been developed and used in a standard procedure for managing different cancers. However, the prolonged antitumor activity of these drugs may cause the emergence of new toxic effects. The aim of the present review was to discuss the leading toxic effect of the anti-angiogenic agent bevacizumab on ovarian function in female patients of reproductive age, which may be observed and expected during in clinical practice. The majority of bevacizumab-induced side effects are expected to be transient and eliminated within the anticipated drug clearance time frame; however, fundamental investigations on these effects are required for generating more evidence-based practice guidelines.

Carvacrol and Thymol Modulate the Cross-Talk between TNF-α and IGF-1 Signaling in Radiotherapy-Induced Ovarian Failure

“…Increased cancer survival rates in females have raised the immense need for long-term protection against toxicities of cancer therapy [5, 6]. Although some strategies have been used recently, such as oocyte and ovarian tissue cryopreservation for female fertility preservation [43, 44], cytotoxic damage to ovarian stromal and germ cells appears to be progressive and irreversible [43]. In addition, these measures either underuse or require invasive techniques for the collection of ovarian tissues as well as for autologous transplantation [44].…”

Anti‐Angiogenic Alternative and Complementary Medicines for the Treatment of Endometriosis: A Review of Potential Molecular Mechanisms

“…Angiogenesis inhibitors have also been associated with cardiovascular toxicities, such as hypertension, left ventricular systolic dysfunction, heart failure, and conduction abnormalities [ 65 , 66 ]. Anti-angiogenic and potentially damaging effects on fetal development and ovarian dysfunction appears to be a plausible side effect of the angiogenic treatment in cancer therapy [ 67 ]. The effects of long-term use upon side effects, ovarian reserve function, and pregnancy safety for women's issues and other issues require further study.…”

Targeted cancer treatment and fertility: effect of immunotherapy and small molecule inhibitors on female reproduction

“…Though designed to bind tumor-specific receptors and ligands, their off-target binding to normal tissue (also known as "on-target toxicity") places recipients at risk for unwanted effects [ (Kizhedath et al, 2017), (Sewell et al, 2017)]. This is likely the case in the setting of female fertility [ (Imai et al, 2017)]. Additional damage may be caused via binding to targets on healthy tissue which share similar structure to their intended targets (also known as "off-target toxicity").…”