Biomarker prediction of chemotherapy-related amenorrhea

• 作 者: KathrynJeanRuddy[1]AnneM.O'Neill[2]KathyMiller[3]BryanP.Schneider[4]EmilyBaker[5]JosephA.Sparano[6]ChauT.Dang;DonaldW.Northfelt;GeorgeW.Sledge;
• 机 构: Dana-Farber Cancer Institute,Boston,MA
• 出 处: 2013年临床肿瘤学新进展学术研讨会
• 发表日期: 2013年期

　　Background: Chemotherapy-related amenorrhea(CRA)is associated with infertility and may impact treatment decision-making.We investigated whether anti-mullerian hormone(AMH)levels before chemotherapy predict likelihood of CRA.Methods: 591 patients enrolled on the quality of life substudy of ECOG5103,which randomized breast cancer patients to doxorubicin-cyclophosphamide followed by paclitaxel: 1)alone; 2)with concurrent bevacizumab; or 3)with prolonged bevacizumab.144 of the 195 women who reported a period <12 months before enrollment consented to serum collection prior to chemotherapy.AMH was measured in 143 with available serum.Participants self-reported menstrual frequency at 12 and 18 months after enrollment.12-month CRA was defined as no menses for 6 months before the 12-month survey,and 18-month CRA as no menses for 6 months before the 18-month survey.Fishers exact test was used to identify associations with CRA.Results: Of the 143,16 were excluded due to bilateral oophorectomy or initiation of ovarian function suppression within 12 months,and 2 due to missing data at 12 months.In the remaining 125,median age at enrollment was 45(range 25-55).103(82%)had CRA at 12 months,including 68%of patients 45(60/62).Median pre-chemotherapy AMH was 0.11(range 0.01-8.63).12-month CRA was more likely in women who received bevacizumab(p<0.01),were >45(p<0.01),and had AMH 45.18-month CRA was more likely in women >45(p<0.01)and with AMH