Matteo Lambertini, Marcello Ceppi, Francesca Poggio, Fedro A. Peccatori, Hatem A. Azim Jr., Donatella Ugolini, Paolo Pronzato, Sibylle

Loibl, Halle C. F. Moore, Ann H. Partridge, Paolo Bruzzi, Lucia Del Mastro

Ovarian suppression using luteinizing hormone-releasing hormone agonists during chemotherapy to

preserve ovarian function and fertility of breast cancer patients. A meta-analysis of randomized studies

Press Conference, ECC2015 (abstract: 1957)

September 27th, 2015Vienna, Austria

Presented at the Press Conference, ECC2015 Presented by: Matteo Lambertini, MD

Study Background (1/2)• Approximately 11% of breast cancer occur in women younger

than 45 years (25,500 in the US every year) with 6% in women under 40.

• Up to 97% will receive chemotherapy and are at risk for premature ovarian failure and infertility.

• Nearly 50% of young cancer survivors desire a pregnancy.

• Available options for fertility preservation: cryopreservation of embryos or oocytes, cryopreservation of ovarian tissue and temporary ovarian suppression with luteinizing hormone-releasing hormone (LHRHa) during chemotherapy.

Presented at the Press Conference, ECC2015 Presented by: Matteo Lambertini, MD

Study Background (2/2)• Cryopreservation of embryos or oocytes are standard strategies;

2-week delay to start anticancer therapies, surgical procedure and no ovarian function preservation.

• Temporary ovarian suppression with LHRHa during chemotherapy: no delay, widely availability, preservation of both ovarian function and fertility.

• The 2013 ASCO and ESMO guidelines still consider the use of LHRHa as an experimental strategy.

• The available randomized studies on LHRHa reported conflicting results; there is paucity of data available on long-term outcomes (pregnancies and survival events).

Presented at the Press Conference, ECC2015 Presented by: Matteo Lambertini, MD

Results (1/2)

Presented at the Press Conference, ECC2015 Presented by: Matteo Lambertini, MD

Results (2/2)

No. studies

No. patients

ResultLHRHa vs control

P value I2

Premature Ovarian Failure

12 1,231 18.5% vs 33.5%OR=0.36

<0.001 47.1%

One-year Amenorrhea

8 882 31.0% vs 42.9%OR=0.55

<0.001 0.0%

Patients with Pregnancy

5 706 33 vs 19 OR=1.83

0.041 0.0%

Disease-Free Survival Events

3 626 19.5% vs 18.8%HR=1.00

0.939 68.0%

Presented at the Press Conference, ECC2015 Presented by: Matteo Lambertini, MD

Conclusions• Temporary ovarian suppression with LHRHa in young breast

cancer patients is associated with a reduced risk of chemotherapy-induced premature ovarian failure and seems to increase the pregnancy rate, without apparent negative consequence on prognosis.

• The use of LHRHa during chemotherapy might be considered as an option for women interested in preserving their ovarian function, and might also play a role in increasing the likelihood of becoming pregnant after cessation of chemotherapy

matteo.lambertini85@gmail.com