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Testicular function after non-cytotoxic and immunotherapy drug treatment

David J Handelsman1,2, Amanda Idan1, Sue Sleiman1

  • 1Andrology Department and Clinical Andrology Laboratory, Concord Hospital, Sydney, New South Wales, Australia.

Andrology
|October 27, 2023
PubMed
Abstract

Insights

Novel cancer drugs like non-cytotoxic and immunotherapy treatments moderately impact sperm production and related hormones, with minimal effect on testosterone levels in men undergoing treatment.

Area of Science:

  • Reproductive Endocrinology
  • Oncology
  • Pharmacology

Background:

  • Systematic studies on the effects of novel non-cytotoxic and immunotherapy drugs on human testicular function are lacking.
  • Understanding these effects is crucial for managing cancer patients' reproductive health.

Purpose of the Study:

  • To investigate the impact of non-cytotoxic and immunotherapy drugs on testicular exocrine and endocrine functions.
  • To characterize these effects in cancer patients not previously exposed to gonadotoxic therapies.

Main Methods:

  • A mixed longitudinal and cross-sectional study involving 34 men treated with non-cytotoxic and immunotherapy drugs.
  • Data modeling was used to assess changes in testicular function over time.
  • Semen and blood samples were collected before and during treatment, with long-term follow-up.

Main Results:

  • A ~50% reduction in spermatozoa output and concentration was observed.
  • Serum follicle-stimulating hormone increased, while serum inhibin B decreased.
  • Testosterone, luteinizing hormone, and sex hormone-binding globulin levels remained unaffected.

Conclusions:

  • Non-cytotoxic and immunotherapy drugs exert modest effects on testicular exocrine function and its hormonal regulation (FSH, inhibin B).
  • These treatments show minimal impact on testicular endocrine function, specifically testosterone and LH levels.
  • Further research with larger sample sizes and longer follow-up is warranted.
Keywords:
AMHFSHcancerchronic myeloid leukemiaenzyme inhibitorsimmune checkpoint inhibitorsinhibin Bmelanomanon‐cytotoxic drugsspermatozoatestistestosterone

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