title: Ovarian stimulation in young adult cancer survivors on targeted cancer therapies.
abstract: OBJECTIVE
  To describe a clinical approach to and outcomes of IVF in reproductive-aged cancer survivors receiving targeted cancer therapies.
  
  
  METHODS
  Case report.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  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.
  
  
  METHODS
  In vitro fertilization.
  
  
  METHODS
  Live birth and embryo banking.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  Successful fertility treatments are possible in the context of exposure to crizotinib and denosumab.
authors: Department of Reproductive Medicine, University of California, San Diego, La Jolla, California; Moores Cancer Center, University of California, San Diego, La Jolla, California. Electronic address: hisu@ucsd.edu.
authors: H Irene
authors: HI
authors: Su
authors: Reproductive Partners Medical Group - San Diego, La Jolla, California.
authors: Meghan W
authors: MW
authors: Connell
authors: Moores Cancer Center, University of California, San Diego, La Jolla, California.
authors: Lyudmila A
authors: LA
authors: Bazhenova
mesh_terms: D000328:Adult; D000077548:Anaplastic Lymphoma Kinase; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D001755:Blastocyst; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000201:enzymology / Q000556:secondary; D003110:Colonic Neoplasms / Q000188:drug therapy* / Q000276:immunology / Q000473:pathology; D000077547:Crizotinib; D015925:Cryopreservation; D000069448:Denosumab / Q000008:administration & dosage / Q000009:adverse effects*; D004334:Drug Administration Schedule; D005260:Female; D059247:Fertility Preservation / Q000379:methods*; D005307:Fertilization in Vitro; D006801:Humans; D007247:Infertility, Female / Q000139:chemically induced / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D050498:Live Birth; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000201:enzymology / Q000473:pathology; D058990:Molecular Targeted Therapy; D010062:Ovulation Induction / Q000379:methods*; D011247:Pregnancy; D047428:Protein Kinase Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D011720:Pyrazoles / Q000008:administration & dosage / Q000009:adverse effects*; D011725:Pyridines / Q000008:administration & dosage / Q000009:adverse effects*; D053245:RANK Ligand / Q000037:antagonists & inhibitors / Q000276:immunology; D020794:Receptor Protein-Tyrosine Kinases / Q000037:antagonists & inhibitors / Q000378:metabolism; D013533:Gestational Carriers; D014429:Twins, Dizygotic
chemical_list: D000970:Antineoplastic Agents; D047428:Protein Kinase Inhibitors; D011720:Pyrazoles; D011725:Pyridines; D053245:RANK Ligand; C505688:TNFSF11 protein, human; D000069448:Denosumab; D000077547:Crizotinib; C000626173:ALK protein, human; D000077548:Anaplastic Lymphoma Kinase; D020794:Receptor Protein-Tyrosine Kinases
keywords: Crizotinib; denosumab; fertility preservation; ovarian stimulation; targeted cancer treatment