title: Predictors of recovery of ovarian function during aromatase inhibitor therapy.
abstract: BACKGROUND
  Aromatase inhibitors (AIs) may cause a rise in estrogen levels due to ovarian function recovery in women with clinical chemotherapy-induced ovarian failure (CIOF). We carried out a prospective registry trial to identify predictors of ovarian function recovery during AI therapy.
  
  
  METHODS
  Women with hormone receptor (HR)-positive breast cancer who remained amenorrheic and had hormonal levels consistent with ovarian failure after adjuvant chemotherapy were enrolled in a multi-institutional clinical trial of anastrozole. Subjects underwent frequent assessment using an ultrasensitive estradiol assay. Multivariable analysis was used to evaluate clinical and biochemical predictors of ovarian function recovery within 48 weeks.
  
  
  RESULTS
  Recovery of ovarian function during AI therapy was observed in 13 of 45 (28.9%) assessable subjects after a median 2.1 months (range 0.6-11.9). Median age at chemotherapy initiation was statistically significantly different between those who regained ovarian function (43 years, range 40-51) and those who remained postmenopausal (49 years, range 44-52; P < 0.0001).
  
  
  CONCLUSIONS
  A significant proportion of women with CIOF recover ovarian function during AI therapy, including a woman over age 50 at initiation of chemotherapy. Tamoxifen remains the standard of care for women with CIOF. If an AI is used, patients should be monitored frequently with high-quality estradiol assays. CLINICALTRIALS.GOV: NCT00555477.
authors.affiliation: Breast Oncology Program, University of Michigan Comprehensive Cancer Center, Ann Arbor, MI 48109, USA. norahh@med.umich.edu
authors.forename: N L
authors.initials: NL
authors.lastname: Henry
authors.forename: R
authors.initials: R
authors.lastname: Xia
authors.forename: M
authors.initials: M
authors.lastname: Banerjee
authors.forename: C
authors.initials: C
authors.lastname: Gersch
authors.forename: D
authors.initials: D
authors.lastname: McConnell
authors.forename: D
authors.initials: D
authors.lastname: Giacherio
authors.forename: A F
authors.initials: AF
authors.lastname: Schott
authors.forename: M
authors.initials: M
authors.lastname: Pearlman
authors.forename: V
authors.initials: V
authors.lastname: Stearns
authors.forename: A H
authors.initials: AH
authors.lastname: Partridge
authors.forename: D F
authors.initials: DF
authors.lastname: Hayes
mesh_terms: D000328:Adult; D000568:Amenorrhea; D000077384:Anastrozole; D018906:Antineoplastic Agents, Alkylating / Q000627:therapeutic use; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D047072:Aromatase Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D003520:Cyclophosphamide / Q000627:therapeutic use; D004958:Estradiol / Q000097:blood*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009570:Nitriles / Q000627:therapeutic use; D010053:Ovary / Q000187:drug effects*; D016649:Primary Ovarian Insufficiency / Q000139:chemically induced* / Q000175:diagnosis; D011446:Prospective Studies; D011960:Receptors, Estrogen; D013629:Tamoxifen / Q000627:therapeutic use; D014230:Triazoles / Q000627:therapeutic use; D014592:Uterine Hemorrhage / Q000139:chemically induced
chemical_list: D018906:Antineoplastic Agents, Alkylating; D018931:Antineoplastic Agents, Hormonal; D047072:Aromatase Inhibitors; D009570:Nitriles; D011960:Receptors, Estrogen; D014230:Triazoles; D013629:Tamoxifen; D000077384:Anastrozole; D004958:Estradiol; D003520:Cyclophosphamide
keywords: aromatase inhibitor; breast cancer; chemotherapy-induced ovarian failure; estradiol; ovarian function