在年轻乳腺癌患者的化疗和抗HER2治疗后预测卵巢功能损失
Matteo Lambertini1,2, Deirdre Allegranza3, Ruediger P Laubender4
1Department of Internal Medicine and Medical Specialties (DIMI), School of Medicine, University of Genova, Genoa, Italy.
Journal of the National Cancer Institute
|August 12, 2025
概括
抗穆勒尔激素 (AMH) 有效地预测了经期前妇女的卵巢功能损失与HER2阳性早期乳腺癌接受化疗. 在治疗前和治疗后测量AMH为子不育咨询提供了最好的预测.
科学领域:
- 生殖内分泌学 生殖内分泌学
- 在瘤学瘤学.
- 生物标记分析 生物标记分析
背景情况:
- 预测卵巢功能丧失对于早期乳腺癌 (eBC) 的年轻女性的生育不良咨询和治疗决策至关重要.
- HER2阳性eBC治疗包括化疗和抗HER2疗法,这可能会影响生育能力.
研究的目的:
- 评估抗米勒尔激素 (AMH) 对前绝经妇女的卵巢功能损失的预测价值,具有HER2阳性eBC.
- 评估AMH与卵泡刺激激素 (FSH) 和雌激素 (E2) 的联合效用,以进行预测.
主要方法:
- 来自BETH和KAITLIN随机试验的生物标志物分析.
- 在治疗前,治疗期间和治疗后测量血清AMH,FSH和E2水平在更年期前患有HER2阳性eBC的女性中.
- 使用曲线下的面积 (AUC) 来评估预测准确性的统计分析.
主要成果:
- 在治疗期间,AMH水平显著下降,36个月后观察到部分恢复.
- 基线AMH预测卵巢损失 (AUC=0.784),年龄被包括在内时略有改善 (AUC=0.800).
- 结合基线和治疗结束时的AMH测量,以及年龄,产生了最高的预测准确性 (AUC=0.820). FSH和E2并没有提高预测.
结论:
- 治疗前的AMH测量是这种患者群体中卵巢功能丧失的可靠预测指标.
- 治疗结束时的AMH测量与治疗前评估相当,并增加了价值.
- 这些发现支持AMH作为HER2-阳性eBC治疗的年轻女性生育保护讨论的关键生物标志物.
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