title: A pilot study of predictive markers of chemotherapy-related amenorrhea among premenopausal women with early stage breast cancer.
abstract: BACKGROUND
  Premenopausal women treated for early stage breast cancer (ESBC) are at risk for chemotherapy-related amenorrhea (CRA). Prospectively-validated, predictive markers of CRA are needed.
  
  
  METHODS
  Premenopausal women with ESBC and planned chemotherapy (>/= 25% risk of amenorrhea) were evaluated. Follicle stimulating hormone (FSH), estradiol, Inhibin A and B, anti-Müllerian hormone (AMH), and quality of life (QOL) were prospectively evaluated pre-, post-, 6 months and 1 year post-chemotherapy and correlated with age and menstrual status. CRA was defined as absence of menses 1 year post-chemotherapy.
  
  
  RESULTS
  Forty-four women were evaluated at the time of analysis. Median age at diagnosis and FSH 1 year post-chemotherapy were higher among women with CRA (44 yrs [33-51] vs. 40 yrs [31-43]; p = 0.03; 39.8 vs. 5.0 mLU/mL, p = 0.0058, respectively). Median estradiol 1 year post-chemotherapy was higher among women who resumed menses (108.3 vs. 41.3 pg/mL, p = 0.01). Pre-chemotherapy median Inhibin B and AMH were lower among women with CRA (33.2 vs. 108.8 pg/mL; p = 0.03; 0.16 vs. 1.09 ng/mL, p = 0.02, respectively). The risk of CRA was increased among women with lower pre-chemotherapy Inhibin B (RR = 1.67, p = 0.15) and AMH (RR = 1.83, p = 0.05). Amongst women whose pre-chemotherapy Inhibin B and AMH values were below the median, the incidence of CRA was 87.5%.
  
  
  CONCLUSIONS
  RESULTS indicate that pre-chemotherapy Inhibin B and AMH are lower among women experiencing CRA and may be predictive of CRA among premenopausal women facing chemotherapy for ESBC.
authors.affiliation: Division of Medical Oncology, Duke University Department of Medicine, Durham, North Carolina, USA. ander118@mc.duke.edu
authors.forename: Carey
authors.initials: C
authors.lastname: Anders
authors.forename: P Kelly
authors.initials: PK
authors.lastname: Marcom
authors.forename: Bercedis
authors.initials: B
authors.lastname: Peterson
authors.forename: Lin
authors.initials: L
authors.lastname: Gu
authors.forename: Sue
authors.initials: S
authors.lastname: Unruhe
authors.forename: Renee
authors.initials: R
authors.lastname: Welch
authors.forename: Peggy
authors.initials: P
authors.lastname: Lyons
authors.forename: Millie
authors.initials: M
authors.lastname: Behera
authors.forename: Susannah
authors.initials: S
authors.lastname: Copland
authors.forename: Gretchen
authors.initials: G
authors.lastname: Kimmick
authors.forename: Heather
authors.initials: H
authors.lastname: Shaw
authors.forename: Stacey
authors.initials: S
authors.lastname: Snyder
authors.forename: Monica
authors.initials: M
authors.lastname: Antenos
authors.forename: Teresa
authors.initials: T
authors.lastname: Woodruff
authors.forename: Kimberly
authors.initials: K
authors.lastname: Blackwell
mesh_terms: D000328:Adult; D000367:Age Factors; D000568:Amenorrhea / Q000139:chemically induced*; D054304:Anti-Mullerian Hormone / Q000097:blood; D000970:Antineoplastic Agents / Q000009:adverse effects*; D015415:Biomarkers / Q000097:blood*; D001943:Breast Neoplasms / Q000188:drug therapy*; D004958:Estradiol / Q000097:blood; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D007118:Immunoassay; D007265:Inhibins / Q000097:blood; D008875:Middle Aged; D010865:Pilot Projects; D017697:Premenopause; D011788:Quality of Life
chemical_list: D000970:Antineoplastic Agents; D015415:Biomarkers; C422362:inhibin A; C422364:inhibin B; D004958:Estradiol; D007265:Inhibins; D054304:Anti-Mullerian Hormone; D005640:Follicle Stimulating Hormone