Cyclophosphamide-free Adjuvant Chemotherapy for the Potential Prevention of Premature Ovarian Insufficiency and Infertility in Young Women with Breast Cancer
Mené sur 521 patientes atteintes d'un cancer du sein ER+ HER2- (âge médian : 34 ans), cet essai de phase III évalue l'efficacité, du point de vue du taux de reprise du cycle mentruel à 12 mois et de la survie sans maladie à 5 ans, d'une chimiothérapie adjuvante sans cyclophosphamide après une chirurgie définitive (durée médiane de suivi : 62 mois)
Cyclophosphamide is an important component of most adjuvant breast cancer chemotherapy regimens.1,2However, research has repeatedly demonstrated that it also contributes substantially to the risk of gonadotoxicity in premenopausal women, an issue of great importance for young patients.3,4The development of chemotherapy-induced premature ovarian insufficiency (POI) is not only associated with attendant infertility but also the additional negative health consequences of an early loss of ovarian function.5Together with patient age, type and dose of chemotherapy are the other crucial factors influencing gonadotoxicity risk, with alkylating agents such as cyclophosphamide being associated with the highest negative gonadal impact.3,4,6Therefore, investigating the possibility of effective novel adjuvant chemotherapy regimens with lower risk of this long-term toxicity is a highly relevant clinical question (...)
Journal of the National Cancer Institute , éditorial en libre accès, 2020