@article{406ca04b0be241e1bd9f06fab3bf3d05,
title = "Safety of assisted reproductive techniques in young women harboring germline pathogenic variants in BRCA1/2 with a pregnancy after prior history of breast cancer",
abstract = "Background: Knowledge is growing on the safety of assisted reproductive techniques (ART) in cancer survivors. No data exist, however, for the specific population of breast cancer patients harboring germline BRCA1/2 pathogenic variants. Patients and methods: This is a multicenter retrospective cohort study across 30 centers worldwide including women diagnosed at ≤40 years with stage I-III breast cancer, between January 2000 and December 2012, harboring known germline BRCA1/2 pathogenic variants. Patients included in this analysis had a post-treatment pregnancy either achieved through use of ART (ART group) or naturally (non-ART group). ART procedures included ovulation induction, ovarian stimulation for in vitro fertilization or intracytoplasmic sperm injection, and embryo transfer under hormonal replacement therapy. Results: Among the 1424 patients registered in the study, 168 were eligible for inclusion in the present analysis, of whom 22 were in the ART group and 146 in the non-ART group. Survivors in the ART group conceived at an older age compared with those in the non-ART group (median age: 39.7 versus 35.4 years, respectively). Women in the ART group experienced more delivery complications compared with those in the non-ART group (22.1% versus 4.1%, respectively). No other apparent differences in obstetrical outcomes were observed between cohorts. The median follow-up from pregnancy was 3.4 years (range: 0.8-8.6 years) in the ART group and 5.0 years (range: 0.8-17.6 years) in the non-ART group. Two patients (9.1%) in the ART group experienced a disease-free survival event (specifically, a locoregional recurrence) compared with 40 patients (27.4%) in the non-ART group. In the ART group, no patients deceased compared with 10 patients (6.9%) in the non-ART group. Conclusion: This study provides encouraging safety data on the use of ART in breast cancer survivors harboring germline pathogenic variants in BRCA1/2, when natural conception fails or when they opt for ART in order to carry out preimplantation genetic testing.",
keywords = "ART, BRCA, Breast cancer, Fertility, Pregnancy, Survival",
author = "M. Condorelli and M. Bruzzone and M. Ceppi and A. Ferrari and A. Grinshpun and Hamy, {A. S.} and {de Azambuja}, E. and E. Carrasco and Peccatori, {F. A.} and {Di Meglio}, A. and S. Paluch-Shimon and Poorvu, {P. D.} and M. Venturelli and C. Rousset-Jablonski and C. Senechal and L. Livraghi and R. Ponzone and {De Marchis}, L. and K. Pogoda and A. Sonnenblick and C. Villarreal-Garza and O. C{\'o}rdoba and L. Teixeira and F. Clatot and K. Punie and R. Graffeo and Dieci, {M. V.} and P{\'e}rez-Fidalgo, {J. A.} and Duhoux, {F. P.} and F. Puglisi and Ferreira, {A. R.} and E. Blondeaux and T. Peretz-Yablonski and O. Caron and C. Saule and L. Ameye and J. Balma{\~n}a and Partridge, {A. H.} and Azim, {H. A.} and I. Demeestere and M. Lambertini",
note = "Funding Information: The present work was supported by the Italian Association for Cancer Research (?Associazione Italiana per la Ricerca sul Cancro?, AIRC; MFAG 2020 ID 24698) and the Italian Ministry of Health (5 ? 1000 funds 2017). MC and ID acknowledge the Fonds National de la Recherche Scientifique (FNRS and T?l?vie 7.6508.20) and Fonds Erasme for their financial support. EdA has acted as a scientific advisory board member and has received honoraria from Roche/Genentech, Novartis, Seattle Genetics, Zodiacs, Libbs, Pierre Fabre, and Lilly; has received travel grants from Roche/GNE and GlaxoSmithKline (GSK)/Novartis; and has received research grants through his institution from Roche/GNE, AstraZeneca, GSK/Novartis, and Servier, outside the submitted work. FAP has acted as consultant for Ipsen, Roche Diagnostic, and Merck outside the submitted work. CRJ has acted as a scientific advisory board member and her institution has received honoraria from Bristol Myers Squibb (BMS), Theramex, and Roche; and her institution has received speaker's fees from Theramex and BMS, outside the submitted work. AS has acted as a consultant for Eli Lilly, Pfizer, Novartis, and Roche; has received speaker's fees from Teva, Roche, Pfizer, and Novartis; has received travel grants from Neopharm, Celgene, and Medison; and has received grant support from Novartis and Roche, outside the submitted work. CVG has acted as a consultant, as a scientific advisory board member, and has received speaker's fees from Roche, Novartis, Pfizer, Lilly, and Merck Sharp & Dohme (MSD); and has received research funding from AstraZeneca, Roche, and Pfizer, outside the submitted work. OCC has acted as a scientific advisory board member for Ascires Sistemas Gen?micos; and has received grant support from Roche Diagnostics, Neomedic, and Takeda, outside the submitted work. KP has acted as a scientific advisory board member for AstraZeneca, Eli Lilly, Gilead Sciences, MSD, Novartis, Pierre Fabre, Roche, Teva, and Vifor Pharma; has acted as a consultant for AstraZeneca, Novartis, Pfizer, and Roche; has received speaker's fees from Eli Lilly, Medscape, MSD, Mundi Pharma, Novartis, Pfizer, and Roche; has received travel grants from AstraZeneca, Novartis, Pfizer, PharmaMar, and Roche, outside the submitted work. FP has acted as a scientific advisory board member and has received speaker's fees from Amgen, AstraZeneca, Daichi-Sankyo, Eisai, Eli Lilly, Ipsen, MSD, Novartis, Pierre-Fabre, Pfizer, Roche, Seagen, and Takeda; has received travel grants from Celgene, GlaxoSmithKline, and Roche; and has received research funding from AstraZeneca, Eisai, and Roche, outside the submitted work. ARF has received honoraria from Bayer, Daiichi Sankyo, Novartis, and Roche; and has received travel grants from Roche, outside the submitted work. JB has acted as consultant for AstraZeneca and Pfizer outside the submitted work. ID has acted as a scientific advisory board member and received grant from Roche; has received speaker's fees from Novartis; and has received travel grants from Theramex and Ferring, outside the submitted work. ML has acted as a consultant for Roche, Lilly, AstraZeneca, Exact Sciences, and Novartis; and has received honoraria from Sandoz, Roche, Lilly, Pfizer, Novartis, Ipsen, and Takeda, outside the submitted work. The remaining authors have no conflicts of interest to declare. Funding Information: The present work was supported by the Italian Association for Cancer Research ({\textquoteleft}Associazione Italiana per la Ricerca sul Cancro{\textquoteright}, AIRC; MFAG 2020 ID 24698 ) and the Italian Ministry of Health (5 × 1000 funds 2017). MC and ID acknowledge the Fonds National de la Recherche Scientifique (FNRS and T{\'e}l{\'e}vie 7.6508.20) and Fonds Erasme for their financial support. Publisher Copyright: {\textcopyright} 2021 The Author(s)",
year = "2021",
month = dec,
doi = "10.1016/j.esmoop.2021.100300",
language = "English",
volume = "6",
pages = "1--7",
journal = "ESMO Open",
issn = "2059-7029",
publisher = "Elsevier B.V.",
number = "6",
}
