Anti-mullerian hormone as a serum biomarker for risk of chemotherapy-induced amenorrhea
Menée à partir de données portant sur 277 patientes atteintes d'un cancer du sein exprimant faiblement HER2 et de stade précoce (âge médian : 39 ans), cette étude évalue l'association entre le niveau sérique de l'hormone anti-müllérienne avant une chimiothérapie ou un an après son commencement et le risque d'aménorrhée liée au traitement
Anti-mullerian hormone (AMH) is a promising biomarker for ovarian reserve. In this study, we assessed AMH before and one year after initiation of adjuvant chemotherapy on NSABP/NRG Oncology B-47 in female participants aged 42 years and younger (with median age 39 years). At baseline, median AMH was 1.2 ng/mL; 13 (4.7%) values were <0.1ng/mL (the threshold for detectable levels, in the perimenopause/menopause range), and 57 values (20.6%) were less than 0.5 ng/mL. At 1 year, 215 (77.6%) were less than 0.1ng/mL, and 264 (95.3%) were less than 0.5 ng/mL. Post-chemotherapy menses were reported by 46.2% of participants. Multivariable logistic regression found that the odds of having post-chemotherapy menses increased with younger age, higher BMI, and higher pre-chemotherapy AMH, but not by trastuzumab administration or by the choice of chemotherapy (doxorubicin-cyclophosphamide followed by paclitaxel vs. docetaxel-cyclophosphamide). We conclude that higher pre-chemotherapy AMH predicts a lower risk of chemotherapy-induced amenorrhea, and that AMH one year after chemotherapy initiation is not informative in this setting because it is likely to be very low.
Journal of the National Cancer Institute , résumé, 2019