Infertility risk and teratogenicity of molecularly targeted anticancer therapy: A challenging issue

Area of Science:

• Oncology
• Reproductive Medicine
• Pharmacology

Background:

• Increasing numbers of young cancer survivors and delayed childbearing necessitate understanding treatment effects on fertility.
• While cytotoxic agents' fertility risks are known, those of molecular targeted therapies remain largely unestablished.
• Fertility preservation is a critical concern for cancer patients planning future pregnancies.

Purpose of the Study:

• To review and synthesize preclinical and clinical data on the impact of molecular targeted agents on male and female fertility.
• To assess the teratogenic potential of these novel cancer therapies.
• To provide evidence-based recommendations for clinicians managing cancer patients of reproductive age.

Main Methods:

• Systematic review of preclinical and clinical studies on molecular targeted agents and fertility.
• Categorization of agents by drug class and targeted signaling pathways.
• Evaluation of data regarding effects on spermatogenesis, oogenesis, and potential teratogenicity.

Main Results:

• Data on fertility and teratogenic effects of molecular targeted therapies are limited but emerging.
• Specific targeted agents show varying degrees of impact on gonadal function in preclinical and clinical settings.
• Understanding the targeted pathways offers insights into potential reproductive toxicity.

Conclusions:

• Molecular targeted therapies represent a potential risk to fertility and pose teratogenic concerns that require careful consideration.
• Further research is crucial to establish definitive risks and inform fertility preservation strategies.
• Clinicians should discuss reproductive risks with patients initiating molecular targeted therapies and consider fertility-sparing options.