Targeted cancer treatment and fertility: effect of immunotherapy and small molecule inhibitors on female reproduction

Reprod Biomed Online. 2022 Jan;44(1):81-92. doi: 10.1016/j.rbmo.2021.09.004. Epub 2021 Sep 17.

Abstract

Targeted cancer therapy is rapidly evolving the landscape of personalized health care. Novel approaches to selectively impeding tumour growth carry significant potential to improve survival outcomes, particularly for reproductive-aged patients harbouring treatment refractory disease. Current agents fall within two classes: immunotherapy and small molecule inhibitors. These are collectively divided into the following subclasses: monoclonal antibodies; immunomodulators; adoptive cell therapy; treatment vaccines; kinase inhibitors; proteasome inhibitors; metalloproteinase and heat shock protein inhibitors; and promoters of apoptosis. The short- and long-term effects of these treatments on the female reproductive system are not well understood. As a result, clinicians are rendered unable to appropriately counsel women on downstream effects to their fertility. Data-driven consensus recommendations are desperately needed. This review aims to characterize the effect of targeted cancer therapy on the female hypothalamic-pituitary-ovary axis, direct ovarian function and conception.

Keywords: Fertility; Immunotherapy; Reproduction; Small molecule inhibitor; Targeted cancer therapy.

Publication types

  • Review

MeSH terms

  • Adult
  • Female
  • Fertility
  • Humans
  • Immunologic Factors / therapeutic use
  • Immunotherapy*
  • Neoplasms* / drug therapy
  • Ovary
  • Reproduction

Substances

  • Immunologic Factors