Ovarian stimulation in young adult cancer survivors on targeted cancer therapies

Successful fertility treatments are possible in the context of exposure to anaplastic lymphoma kinase inhibitors, specifically crizotinib, and RANKL antibody, specifically denosumab.

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Volume 106, Issue 6, Pages 1475-1478

Authors:

H. Irene Su, M.D., M.S.C.E., Meghan W. Connell, B.S., Lyudmila A. Bazhenova, M.D.

Abstract:

Objective

To describe a clinical approach to and outcomes of IVF in reproductive-aged cancer survivors receiving targeted cancer therapies.

Design

Case report.

Setting

Academic fertility preservation program.

Patient(s)

The first case is of a female patient with metastatic lung cancer receiving long-term crizotinib, an anaplastic lymphoma kinase inhibitor. The second case is of a female patient with metastatic colon cancer receiving long-term denosumab, a RANKL antibody. Both patients presented desiring fertility.

Intervention(s)

In vitro fertilization.

Main Outcome Measure(s)

Live birth and embryo banking.

Result(s)

The potential impact of targeted therapy on oocytes and pregnancy was investigated via literature review and pharmaceutical company inquiries. After oncologic, fertility, and psychological counseling, both survivors underwent ovarian stimulation, IVF, and preimplantation genetic screening. One couple achieved live births of dizygotic twins via gestational surrogacy. The second couple froze one euploid blastocyst for future fertility. Both survivors are stable from their cancer standpoints.

Conclusion(s)

Successful fertility treatments are possible in the context of exposure to crizotinib and denosumab.


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Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

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