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Chemotherapy-induced amenorrhea (CIA) risk associated with taxane/platinum-based chemotherapy in young (≤45 years) breast cancer patients.
Abstracts that were granted an exception in accordance with ASCO's Conflict of Interest Policy are designated with a caret symbol (^).
Background: Twenty-five percent of women with breast cancer (BC) are premenopausal and 15% are diagnosed in reproductive age group (≤45 years), thus at risk of CIA. Although CIA rates with alkylating agents/topoisomerase inhibitors (Alk/Topo) are well documented, there is inadequate data addressing the impact of newer Docetaxel/Carboplatin(TP) regimen on menstrual function. The objective of this study was to determine the incidence of long-term (>12 months) CIA related to different chemotherapy regimens in BC patients < 45 years. Methods: We identified 283 premenopausal women with BC ≤ 45 years treated with at least 4 cycles of Neo/adjuvant chemotherapy at University of Kansas from 2005 to 2012. Menstrual status information was extracted from medical records. Standard statistical methods were used to assess the association of CIA with variables of interest. Results: 165 patients met eligibility criteria and had sufficient follow up. Median age: 39 years(24–45 yrs), 62%:<41 years and 38%:41-45 years. 41%:HR+, 20%:HER2+/HR+, 12%:HER2+/HR-, 27%: TNBC. 79%(130/165) received Alk/Topo regimens (AC+/-T= 113, TAC=8, TC=9) and 21%(35/165) received TP regimen. Median ages of patients receiving Alk/Topo and TP regimens was similar. The overall rate of CIA was 34%. BMI, smoking, parity & Tamoxifen use did not impact CIA. Rates of CIA were lower in younger patients and in patients receiving TP chemotherapy. When examined by age at diagnosis CIA rates were 17% (<41yrs) and 63% (>41yrs), respectively (P<0.001). When examined by chemotherapy type the rates of CIA were 42% (Alk/Topo group) and 6% (TP group), respectively (p<0.001) in all patients and 22% (Alk/Topo group) and 0% (TP group) in patients <41 years (p=0.010). Conclusions: Risk of long term CIA with TP regimen is much lower (6%) compared with Alk/Topo regimens (42%) in premenopausal women ≤ 45 years. Premature menopause is associated with considerable side effects like menopausal symptoms, loss of fertility, risk of osteoporosis and cardiovascular disease. Information regarding CIA rates of different chemotherapy regimens is of value to young patients and physicians to aid in adjuvant chemotherapy regimen decision making.
Abstracts by Priyanka Sharma:
Prognosis of triple negative breast cancer patients who attain pathological complete response with neoadjuvant carboplatin/docetaxel and do not receive adjuvant anthracycline chemotherapy.Meeting: 2016 ASCO Annual Meeting | Abstract No: 1015
- Meeting: 2015 ASCO Annual Meeting | Abstract No: 1039
Outcomes with neoadjuvant versus adjuvant chemotherapy for T1-2 node negative triple negative breast cancer.Meeting: 2015 ASCO Annual Meeting | Abstract No: 1092