Protective effects of D-Trp6-luteinising hormone-releasing hormone microcapsules against cyclophosphamide-induced gonadotoxicity in female rats

Bokser, L.; Szende, B.; Schally, Andrew V.

doi:10.1038/bjc.1990.192

Cited by 77 publications

(50 citation statements)

References 32 publications

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“…With this procedure, we may have reduced the likelihood of ovarian damage, because it has been shown that the ovarian epithelium is in G0-phase after the administration of the Gn-RH analogue. 26 We also adopted another strategy: total estrogenic blockade in patients with ER-positive tumors. In fact, in the second part of the study, patients who had ER-positive tumors received an aromatase inhibitor, anastrazole, during their therapy with the Gn-RH analogue.…”

Section: Discussionmentioning

confidence: 99%

Gonadotropin‐releasing hormone analogues added to adjuvant chemotherapy protect ovarian function and improve clinical outcomes in young women with early breast carcinoma

Recchia

Saggio

Amiconi

et al. 2005

Cancer

120

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BACKGROUND The objective of the current study was a retrospective evaluation of 100 consecutive premenopausal women with high‐risk, early breast carcinoma who received a gonadotropin‐releasing hormone (Gn‐RH) analogue as ovarian protection during adjuvant chemotherapy. METHODS After surgery, patients received a Gn‐RH analogue and adjuvant chemotherapy, which was tailored to their peculiar biologic features. The median patient age was 43 years (range, 27–50 yrs). Fifty‐two women had positive estrogen receptor (ER) status, and 48 women had negative ER status. There were 64 women with Stage II breast carcinoma and 36 women with UICC Stage III breast carcinoma. All patients had their serum estradiol suppressed to values < 40 pg/mL. The chemotherapy regimens administered included cyclophosphamide, methotrexate, and 5‐fluorouracil (n = 26 patients) and anthracycline‐based regimens (n = 74 patients, including 9 patients who had > 10 positive axillary lymph nodes, who also received high‐dose chemotherapy with autologous peripheral blood progenitor cell transplantation). Patients with positive c‐erb‐2 status also received a taxane. Eighty patients received radiation therapy. During therapy with the Gn‐RH analogue, patients who had a positive ER status after chemotherapy received an aromatase inhibitor. RESULTS After a median follow‐up of 75 months, normal menses were resumed by all patients younger than age 40 years and by 56% of patients older than age 40 years. Three pregnancies were observed that resulted in two normal deliveries and one voluntary abortion. The projected recurrence‐free survival rates at 5 years and 10 years were 84% and 76%, respectively; and the projected overall survival rates at 5 years and 10 years were 96% and 91%, respectively. CONCLUSIONS The current data showed that, in premenopausal women with early breast carcinoma, the addition of a Gn‐RH analogue to adjuvant therapy and temporary total estrogen suppression in patients with ER‐positive disease was tolerated well, protected long‐term ovarian function, and appeared to improve the expected clinical outcome. Cancer 2006. © 2005 American Cancer Society.

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Section: Discussionmentioning

confidence: 99%

Gonadotropin‐releasing hormone analogues added to adjuvant chemotherapy protect ovarian function and improve clinical outcomes in young women with early breast carcinoma

Recchia

Saggio

Amiconi

et al. 2005

Cancer

120

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“…Animal studies and phase Ⅱ clinical research have suggested that GnRHa can lead to temporary ovarian suppression to preserve ovarian function (4)(5)(6). Recently, several studies have been conducted on the ovarian function preservation in young women undergoing gonadotoxic chemotherapy.…”

Section: Introductionmentioning

confidence: 99%

Protection of ovarian function by GnRH agonists during chemotherapy: A meta-analysis

Sun

Dongol

Jiang

et al. 2014

International Journal of Oncology

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Abstract. This meta-analysis was designed to assess the overall performance of GnRHa in preserving the ovarian function in young women undergoing chemotherapy. Electronic literature databases including Pubmed, MEDLINE, Cochrane library, Embase, CNKI and Wanfang were searched for articles published till November, 2013. The articles written in both Chinese and English were considered. Only randomized controlled trials (RCTs) were selected. Main Outcome Measure was evaluated by assessing the post-chemotherapy ovarian function. A random-effects model was used to calculate the risk ratio (RR) and associated 95% confidence intervals (95% CI). Out of the eight RCTs including 621 patients, 321 women were treated with GnRHa during chemotherapy, 9.66% of whom suffered premature ovarian failure (POF). On the other hand, 26.67% of the remaining 300 women suffered POF. More women treated without GnRHa experienced post-chemotherapy POF, yielding an RR of 0.45 [chemotherapy plus GnRHa vs. chemotherapy alone, 95% confidence interval (CI) (0.22, 0.92)]. Based on the available studies, GnRHa plays an important role in the prevention of post-chemotherapy POF, but does not exhibit its protective effects in fertility.

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“…[1][2][3] Over the last 10 years, more than a dozen reports of small cohorts of women undergoing chemotherapy with concomitant GnRHa therapy have been published, most with resoundingly positive results. In this paper, we performed a meta-analysis of the published literature that compares GnRHa cotherapy during chemotherapy with chemotherapy alone to determine if GnRHa can improve ovarian preservation and maintain fertility.…”

Section: Introductionmentioning

confidence: 99%

Ovarian Preservation by GnRH Agonists during Chemotherapy: A Meta-Analysis

Clowse

Behera

Anders

et al. 2009

Journal of Women's Health

202

121

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Purpose: Treatment with cyclophosphamide (CYC) confers up to a 40% risk of ovarian failure in women of reproductive age. The use of GnRH agonists (GnRHa) to preserve ovarian function has been investigated in several small studies. We performed a systematic review of studies examining whether a GnRHa administered during chemotherapy is protective of ovarian function and fertility. Methods: We searched the English-language literature (1966( -April 2007 using MEDLINE and meeting abstracts and included studies that reported an association between GnRHa and ovarian preservation in women receiving chemotherapy. Studies without a control group were excluded. Ovarian preservation was defined as the resumption of menstrual cycles and a premenopausal follicle-stimulating hormone (FSH) after chemotherapy. Fertility was determined by a woman's ability to become pregnant. We estimated the summary relative risk (RR) and associated 95% confidence intervals (95% CI) using a random-effects model. Results: Nine studies included 366 women. Three studies included women with autoimmune disease receiving CYC; six included women with hematologic malignancy receiving combination chemotherapy. In total, 178 women were treated with GnRHa during chemotherapy, 93% of whom maintained ovarian function. Of the 188 women not treated with GnRHa, 48% maintained ovarian function. The use of a GnRHa during chemotherapy was associated with a 68% increase in the rate of preserved ovarian function compared with women not receiving a GnRHa (summary RR ¼ 1.68, 95% CI 1.34-2.1). Among the GnRHa-treated women, 22% achieved pregnancy following treatment compared with 14% of women without GnRHa therapy (summary RR ¼ 1.65, CI 1.03-2.6). Conclusions: Based on the available studies, GnRHa appear to improve ovarian function and the ability to achieve pregnancy following chemotherapy. Several randomized trials are underway to define the role and mechanism of GnRHa in ovarian function preservation. In the meantime, premenopausal women facing chemotherapy should be counseled about ovarian preservation options, including the use of GnRHa therapy.

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Protective effects of D-Trp6-luteinising hormone-releasing hormone microcapsules against cyclophosphamide-induced gonadotoxicity in female rats

Cited by 77 publications

References 32 publications

Gonadotropin‐releasing hormone analogues added to adjuvant chemotherapy protect ovarian function and improve clinical outcomes in young women with early breast carcinoma

Gonadotropin‐releasing hormone analogues added to adjuvant chemotherapy protect ovarian function and improve clinical outcomes in young women with early breast carcinoma

Protection of ovarian function by GnRH agonists during chemotherapy: A meta-analysis

Ovarian Preservation by GnRH Agonists during Chemotherapy: A Meta-Analysis

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