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Proffered Paper session: Supportive and palliative care

1551O - Factors associated with chemotherapy (CT)-related amenorrhea (CRA) and its relationship with quality of life (QOL) in premenopausal women with early breast cancer (BC): Results from the prospective CANTO cohort study

Date

11 Sep 2022

Session

Proffered Paper session: Supportive and palliative care

Topics

Supportive Care and Symptom Management

Tumour Site

Breast Cancer

Presenters

Rayan Kabirian

Citation

Annals of Oncology (2022) 33 (suppl_7): S713-S742. 10.1016/annonc/annonc1075

Authors

R. Kabirian1, J. Havas2, M.A. Franzoi2, C. Coutant3, O. Tredan4, C. Levy5, P.H. Cottu6, A. Dhaini Merimeche7, S. GUILLERMET8, J. Ferrero9, S. Giacchetti10, T. Petit11, F. Dalenc12, P. Rouanet13, O. Querel14, A. Martin15, B. Pistilli1, M. Lambertini16, I. Vaz Luis2, A. Di Meglio2

Author affiliations

  • 1 Oncology, Institut Gustave Roussy, 94805 - Villejuif, Cedex/FR
  • 2 Inserm Unit U 981, Institut Gustave Roussy, 94805 - Villejuif, Cedex/FR
  • 3 Surgical Oncology, Centre Georges Francois Leclerc, 21000 - Dijon/FR
  • 4 Medical Oncology, Centre Léon Bérard, 69008 - Lyon/FR
  • 5 Oncology, Centre Francois Baclesse, 14076 - Caen/FR
  • 6 Medical Oncology, Institut Curie, 75005 - Paris/FR
  • 7 Oncology, Institut de Cancérologie de Lorraine - Alexis Vautrin, 54519 - Vandoeuvre-lès-Nancy/FR
  • 8 Surgical Oncology, Centre Eugene - Marquis, 35042 - Rennes/FR
  • 9 Oncology, Centre Antoine Lacassagne, 06189 - Nice/FR
  • 10 Oncology, Hopital Saint Louis - Groupe Hospitalier La Rochelle-Ré-Aunis, 17019 - La Rochelle/FR
  • 11 Medical Oncology, Centre Paul Strauss Centre de Lutte contre le Cancer, 67065 - Strasbourg/FR
  • 12 Oncology, Centre Claudius-Regaud, 31052 - Toulouse/FR
  • 13 Surgical Oncology, CRLC Val d'Aurelle, 34090 - Montpellier/FR
  • 14 Research, Unicancer, 75654 - Paris, Cedex /FR
  • 15 Research, UNICANCER, 75654 - Paris/FR
  • 16 Internal Medicine Dept., IRCCS Ospedale Policlinico San Martino, 16132 - Genova/IT
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Resources

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Abstract 1551O

Background

CRA is common among premenopausal women with early BC and may determine substantial impact on post-CT QOL. We examined factors associated with CRA in a modern cohort of patients receiving current standard (neo)adjuvant CT regimens (anthracycline [A]- and taxane [T]-based) and the relationship between CRA and long-term QOL.

Methods

We used CANTO, a multicenter, prospective cohort of stage I–III BC (NCT01993498) to include premenopausal women aged ≤50 years at BC diagnosis, treated with CT, and not receiving adjuvant ovarian-function suppression. In the main analysis, our outcome of interest was CRA at year-1 (Y1), year-2 (Y2), and year-4 (Y4) after diagnosis. Multivariable logistic regression models assessed associations between CRA at each time-point and covariates. Among women with follow-up (FU) ≥4 years and menses status available at all time-points, multivariable linear regression models assessed the relationship between persistent CRA (defined as never resumption of menses) and QOL at Y4 (EORTC QLQ-C30/BR23), adjusting for QOL at diagnosis and all covariates.

Results

Among 1676 women, mean age at diagnosis was 42.2 years (SD 5.6). 83.1% reported CRA at Y1, 72.8% at Y2 and 66.7% at Y4, with expected variability across age groups and other patient characteristics (Table). Among 745 women with FU ≥ 4 years, 57.7% had persistent CRA, which was associated with worse sexual function (estimate vs resumption at any time -7,0 [95% CI -12,1 to -1,9]) and more long-term CT-related side effects (i.e. dry mouth, dysgeusia, hot flushes, headaches, alopecia; +3,0 [95% CI +0,1 to +6,0]). Table: 1551O

Factors associated with CRA

Y1 Y2 Y4
% CRA OR* % CRA OR* % CRA OR*
Age 18-34 35-39 40-44 ≥45 53 72 87 95 - 2,0 (1,2-3,5) 6,3 (3,6-11,3) 26,5 (12,7-55,2) 27 51 78 93 - 3,1 (1,6-5,8) 9,6 (5,1-17,9) 39,0 (19,2-79,2) 23 44 73 89 - 2,0 (0,9-4,3) 7,9 (3,7-16,7) 22,5 (10,0-50,7)
BMI 18,5-25 ≥25 <18,5 84 81 92 - 0,6 (0,4-0,9) 5,2 (1,2-23,1) 72 74 72 - 1,0 (0,7-1,4) 1,3 (0,6-3,0) 66 69 55 - 1,0 (0,7-1,6) 0,6 (0,2-1,4)
CT type AT A T 84 64 83 - 0,2 (0,1-0,5) 0,4 (0,2-0,8) 73 60 76 - 0,3 (0,1-0,9) 0,7 (0,3-1,4) 67 65 61 - 0,8 (0,2-2,5) 0,4 (0,2-0,9)
Hormonotherapy No Yes 73 87 - 2,1 (1,4-3,2) 57 77 - 2,3 (1,5-3,4) 59 69 - 1,7 (1,1-2,8)

*Adjusted by socioeconomic, comorbidities, n. children, age at menarche, smoke, alcohol; (95% CI)

Conclusions

Most women reported CRA, including more than half with persistent CRA. Older age, receipt of hormonotherapy, combination of AT and a lower BMI were associated with higher rates of CRA. Persistent CRA was associated with worse sexual function and long-term CT-related side effects.

Clinical trial identification

NCT01993498.

Editorial acknowledgement

Legal entity responsible for the study

Unicancer.

Funding

Conquer Cancer, the ASCO Foundation and Rising Tide Foundation for Clinical Cancer Research.

Disclosure

B. Pistilli: Financial Interests, , Invited Speaker: AstraZeneca, Pierre Fabre, Myriad; Financial Interests, Advisory Board: AstraZeneca, Pierre Fabre, Daiichi-Sankyo; Non-Financial Interests, Principal Investigator: Daiichi-Sankyo, AstraZeneca, Pierre Fabre, Merus, Puma; Financial Interests: Pfizer, Gilead. M. Lambertini: Financial Interests, Advisory Board: Roche, Novartis, Lilly, AstraZeneca, Exact Sciences, MSD, Pfizer, Seagen, Gilead; Financial Interests, Invited Speaker: Roche, Novartis, Lilly, Pfizer, Takeda, Ipsen, Knight, Libbs, Sandoz. I.V. Luis: Financial Interests, Institutional, Invited Speaker: Amgen, Pfizer/Edimark, Pfizer/Edimark, AstraZeneca. All other authors have declared no conflicts of interest.

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