Australian researchers have found that some cancer immunotherapies can impair fertility, calling for further research and precautions such as egg freezing.
In preclinical trials led by experts from Monash University’s Institute for Biomedical Discovery and the Peter McCallum Cancer Center, a common type of immunotherapeutic drug known as an immune checkpoint inhibitor has been shown to affect the ovaries and eggs of mice. Proven to cause permanent damage.
Conventional cancer treatments such as chemotherapy and radiation therapy are already known to adversely affect the ovaries, causing infertility and premature menopause in young girls and women, but immunotherapy anticancer agents Potential side effects on fertility were previously unknown.
of study They found that checkpoint inhibitors, which increase the body’s ability to fight cancer, can impair immediate and future fertility by reducing egg number and quality, preventing ovulation, and disrupting the reproductive cycle. did.
Monash Biomedicine Discovery Institute co-lead author and PhD candidate Lauren Alesi said in a media release on Friday that human research needs to be prioritized.
“Initially, these treatments were generally thought to be less damaging (than chemotherapy and radiotherapy) in the context of off-target effects on the body.
“However, it is clear that other organ system inflammatory side effects are very common with these drugs.
“Our study highlights the need for caution by clinicians and their patients where fertility may be a concern.”
Appropriate intervention needed
Sherene Loi, an expert in breast cancer, professor of oncology and senior author of the study, said that appropriate interventions that can maintain fertility and ovarian function before cancer treatment can be used to promote pregnancy after treatment. said it can.
“These interventions need to be implemented in a timely manner so as not to delay anticancer treatment,” she said.
“Immunotherapy is now becoming the standard of care for many women with curable early-stage breast cancer, with impressive results in reducing breast cancer recurrence, but more research is needed on the long-term effects of immunotherapy. ”
Apart from drugs that block hormone production during chemotherapy and strategies to prevent premature menopause in young women, Alesi says egg and embryo freezing is the only fertility-preserving method currently available. Stated.
However, she noted that embryo freezing is costly, invasive, does not prevent ovarian damage, and premature menopause may still pose a risk to these women.
“Thus, our current priority is to investigate targeted ovarian preservation strategies aimed at preventing ovarian damage from occurring in the first place without interfering with the ability of drugs to fight cancer.” she said.
Alesi added that the results of the study indicate that other immunotherapy classes should also be evaluated.
“Our results reveal a close relationship between immune cells, the communication molecules (cytokines) they release, and the regulation of many aspects of fertility, and thus have implications for other immunotherapies.” There is a possibility.