{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T19:47:33Z","timestamp":1791402453119,"version":"4.3.3"},"reference-count":28,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"19","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO"],"published-print":{"date-parts":[[2018,7,1]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>The role of temporary ovarian suppression with gonadotropin-releasing hormone agonists (GnRHa) during chemotherapy as a strategy to preserve ovarian function and fertility in premenopausal women remains controversial. This systematic review and meta-analysis using individual patient\u2013level data was conducted to better assess the efficacy and safety of this strategy in patients with early breast cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The trials in which premenopausal women with early breast cancer were randomly assigned to receive (neo)adjuvant chemotherapy alone or with concurrent GnRHa were eligible for inclusion. Primary end points were premature ovarian insufficiency (POI) rate and post-treatment pregnancy rate. Disease-free survival and overall survival were secondary end points. Because each study represents a cluster, statistical analyses were performed using a random effects model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 873 patients from five trials were included. POI rate was 14.1% in the GnRHa group and 30.9% in the control group (adjusted odds ratio, 0.38; 95% CI, 0.26 to 0.57; P &lt; .001). A total of 37 (10.3%) patients had at least one post-treatment pregnancy in the GnRHa group and 20 (5.5%) in the control group (incidence rate ratio, 1.83; 95% CI, 1.06 to 3.15; P = .030). No significant differences in disease-free survival (adjusted hazard ratio, 1.01; 95% CI, 0.72 to 1.42; P = .999) and overall survival (adjusted hazard ratio, 0.67; 95% CI, 0.42 to 1.06; P = .083) were observed between groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our findings provide evidence for the efficacy and safety of temporary ovarian suppression with GnRHa during chemotherapy as an available option to reduce the likelihood of chemotherapy-induced POI and potentially improve future fertility in premenopausal patients with early breast cancer.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1200\/jco.2018.78.0858","type":"journal-article","created":{"date-parts":[[2018,5,2]],"date-time":"2018-05-02T15:59:36Z","timestamp":1525276776000},"page":"1981-1990","update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":350,"title":["Gonadotropin-Releasing Hormone Agonists During Chemotherapy for Preservation of Ovarian Function and Fertility in Premenopausal Patients With Early Breast Cancer: A Systematic Review and Meta-Analysis of Individual Patient\u2013Level Data"],"prefix":"10.1200","volume":"36","author":[{"given":"Matteo","family":"Lambertini","sequence":"first","affiliation":[{"name":"Matteo Lambertini, Institut Jules Bordet, Universit\u00e9 Libre de Bruxelles, Brussels, Belgium; Halle C.F. Moore, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH; Robert C.F. Leonard, Imperial College, London; Richard A. Anderson, University of Edinburgh, Edinburgh; Douglas J.A. Adamson, Ninewells Hospital, Dundee; Gianfilippo Bertelli, Sussex Cancer Centre, Brighton, United Kingdom; Sibylle Loibl, Keyur Mehta, and Sabine Seiler, German Breast Group, Neu-Isenburg; Bernd Gerber, University Hospital..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Halle C.F.","family":"Moore","sequence":"additional","affiliation":[{"name":"Matteo Lambertini, Institut Jules Bordet, Universit\u00e9 Libre de Bruxelles, Brussels, Belgium; Halle C.F. Moore, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH; Robert C.F. Leonard, Imperial College, London; Richard A. Anderson, University of Edinburgh, Edinburgh; Douglas J.A. Adamson, Ninewells Hospital, Dundee; Gianfilippo Bertelli, Sussex Cancer Centre, Brighton, United Kingdom; Sibylle Loibl, Keyur Mehta, and Sabine Seiler, German Breast Group, Neu-Isenburg; Bernd Gerber, University Hospital..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert C.F.","family":"Leonard","sequence":"additional","affiliation":[{"name":"Matteo Lambertini, Institut Jules Bordet, Universit\u00e9 Libre de Bruxelles, Brussels, Belgium; Halle C.F. Moore, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH; Robert C.F. Leonard, Imperial College, London; Richard A. Anderson, University of Edinburgh, Edinburgh; Douglas J.A. Adamson, Ninewells Hospital, Dundee; Gianfilippo Bertelli, Sussex Cancer Centre, Brighton, United Kingdom; Sibylle Loibl, Keyur Mehta, and Sabine Seiler, German Breast Group, Neu-Isenburg; Bernd Gerber, University Hospital..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sibylle","family":"Loibl","sequence":"additional","affiliation":[{"name":"Matteo Lambertini, Institut Jules Bordet, Universit\u00e9 Libre de Bruxelles, Brussels, Belgium; Halle C.F. Moore, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH; Robert C.F. Leonard, Imperial College, London; Richard A. Anderson, University of Edinburgh, Edinburgh; Douglas J.A. Adamson, Ninewells Hospital, Dundee; Gianfilippo Bertelli, Sussex Cancer Centre, Brighton, United Kingdom; Sibylle Loibl, Keyur Mehta, and Sabine Seiler, German Breast Group, Neu-Isenburg; Bernd Gerber, University Hospital..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pamela","family":"Munster","sequence":"additional","affiliation":[{"name":"Matteo Lambertini, Institut Jules Bordet, Universit\u00e9 Libre de Bruxelles, Brussels, Belgium; Halle C.F. Moore, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH; Robert C.F. Leonard, Imperial College, London; Richard A. Anderson, University of Edinburgh, Edinburgh; Douglas J.A. Adamson, Ninewells Hospital, Dundee; Gianfilippo Bertelli, Sussex Cancer Centre, Brighton, United Kingdom; Sibylle Loibl, Keyur Mehta, and Sabine Seiler, German Breast Group, Neu-Isenburg; Bernd Gerber, University Hospital..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Bruzzone","sequence":"additional","affiliation":[{"name":"Matteo Lambertini, Institut Jules Bordet, Universit\u00e9 Libre de Bruxelles, Brussels, Belgium; Halle C.F. Moore, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH; Robert C.F. Leonard, Imperial College, London; Richard A. Anderson, University of Edinburgh, Edinburgh; Douglas J.A. Adamson, Ninewells Hospital, Dundee; Gianfilippo Bertelli, Sussex Cancer Centre, Brighton, United Kingdom; Sibylle Loibl, Keyur Mehta, and Sabine Seiler, German Breast Group, Neu-Isenburg; Bernd Gerber, University Hospital..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Boni","sequence":"additional","affiliation":[{"name":"Matteo Lambertini, Institut Jules Bordet, Universit\u00e9 Libre de Bruxelles, Brussels, Belgium; Halle C.F. Moore, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH; Robert C.F. Leonard, Imperial College, London; Richard A. Anderson, University of Edinburgh, Edinburgh; Douglas J.A. Adamson, Ninewells Hospital, Dundee; Gianfilippo Bertelli, Sussex Cancer Centre, Brighton, United Kingdom; Sibylle Loibl, Keyur Mehta, and Sabine Seiler, German Breast Group, Neu-Isenburg; Bernd Gerber, University Hospital..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph M.","family":"Unger","sequence":"additional","affiliation":[{"name":"Matteo Lambertini, Institut Jules Bordet, Universit\u00e9 Libre de Bruxelles, Brussels, Belgium; Halle C.F. Moore, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH; Robert C.F. Leonard, Imperial College, London; Richard A. Anderson, University of Edinburgh, Edinburgh; Douglas J.A. Adamson, Ninewells Hospital, Dundee; Gianfilippo Bertelli, Sussex Cancer Centre, Brighton, United Kingdom; Sibylle Loibl, Keyur Mehta, and Sabine Seiler, German Breast Group, Neu-Isenburg; Bernd Gerber, University Hospital..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard A.","family":"Anderson","sequence":"additional","affiliation":[{"name":"Matteo Lambertini, Institut Jules Bordet, Universit\u00e9 Libre de Bruxelles, Brussels, Belgium; Halle C.F. Moore, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH; Robert C.F. Leonard, Imperial College, London; Richard A. Anderson, University of Edinburgh, Edinburgh; Douglas J.A. Adamson, Ninewells Hospital, Dundee; Gianfilippo Bertelli, Sussex Cancer Centre, Brighton, United Kingdom; Sibylle Loibl, Keyur Mehta, and Sabine Seiler, German Breast Group, Neu-Isenburg; Bernd Gerber, University Hospital..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keyur","family":"Mehta","sequence":"additional","affiliation":[{"name":"Matteo Lambertini, Institut Jules Bordet, Universit\u00e9 Libre de Bruxelles, Brussels, Belgium; Halle C.F. Moore, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH; Robert C.F. Leonard, Imperial College, London; Richard A. Anderson, University of Edinburgh, Edinburgh; Douglas J.A. Adamson, Ninewells Hospital, Dundee; Gianfilippo Bertelli, Sussex Cancer Centre, Brighton, United Kingdom; Sibylle Loibl, Keyur Mehta, and Sabine Seiler, German Breast Group, Neu-Isenburg; Bernd Gerber, University Hospital..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Minton","sequence":"additional","affiliation":[{"name":"Matteo Lambertini, Institut Jules Bordet, Universit\u00e9 Libre de Bruxelles, Brussels, Belgium; Halle C.F. Moore, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH; Robert C.F. Leonard, Imperial College, London; Richard A. Anderson, University of Edinburgh, Edinburgh; Douglas J.A. Adamson, Ninewells Hospital, Dundee; Gianfilippo Bertelli, Sussex Cancer Centre, Brighton, United Kingdom; Sibylle Loibl, Keyur Mehta, and Sabine Seiler, German Breast Group, Neu-Isenburg; Bernd Gerber, University Hospital..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Poggio","sequence":"additional","affiliation":[{"name":"Matteo Lambertini, Institut Jules Bordet, Universit\u00e9 Libre de Bruxelles, Brussels, Belgium; Halle C.F. Moore, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH; Robert C.F. Leonard, Imperial College, London; Richard A. Anderson, University of Edinburgh, Edinburgh; Douglas J.A. Adamson, Ninewells Hospital, Dundee; Gianfilippo Bertelli, Sussex Cancer Centre, Brighton, United Kingdom; Sibylle Loibl, Keyur Mehta, and Sabine Seiler, German Breast Group, Neu-Isenburg; Bernd Gerber, University Hospital..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathy S.","family":"Albain","sequence":"additional","affiliation":[{"name":"Matteo Lambertini, Institut Jules Bordet, Universit\u00e9 Libre de Bruxelles, Brussels, Belgium; Halle C.F. Moore, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH; Robert C.F. Leonard, Imperial College, London; Richard A. Anderson, University of Edinburgh, Edinburgh; Douglas J.A. Adamson, Ninewells Hospital, Dundee; Gianfilippo Bertelli, Sussex Cancer Centre, Brighton, United Kingdom; Sibylle Loibl, Keyur Mehta, and Sabine Seiler, German Breast Group, Neu-Isenburg; Bernd Gerber, University Hospital..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas J.A.","family":"Adamson","sequence":"additional","affiliation":[{"name":"Matteo Lambertini, Institut Jules Bordet, Universit\u00e9 Libre de Bruxelles, Brussels, Belgium; Halle C.F. Moore, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH; Robert C.F. Leonard, Imperial College, London; Richard A. Anderson, University of Edinburgh, Edinburgh; Douglas J.A. Adamson, Ninewells Hospital, Dundee; Gianfilippo Bertelli, Sussex Cancer Centre, Brighton, United Kingdom; Sibylle Loibl, Keyur Mehta, and Sabine Seiler, German Breast Group, Neu-Isenburg; Bernd Gerber, University Hospital..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernd","family":"Gerber","sequence":"additional","affiliation":[{"name":"Matteo Lambertini, Institut Jules Bordet, Universit\u00e9 Libre de Bruxelles, Brussels, Belgium; Halle C.F. Moore, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH; Robert C.F. Leonard, Imperial College, London; Richard A. Anderson, University of Edinburgh, Edinburgh; Douglas J.A. Adamson, Ninewells Hospital, Dundee; Gianfilippo Bertelli, Sussex Cancer Centre, Brighton, United Kingdom; Sibylle Loibl, Keyur Mehta, and Sabine Seiler, German Breast Group, Neu-Isenburg; Bernd Gerber, University Hospital..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy","family":"Cripps","sequence":"additional","affiliation":[{"name":"Matteo Lambertini, Institut Jules Bordet, Universit\u00e9 Libre de Bruxelles, Brussels, Belgium; Halle C.F. Moore, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH; Robert C.F. Leonard, Imperial College, London; Richard A. Anderson, University of Edinburgh, Edinburgh; Douglas J.A. Adamson, Ninewells Hospital, Dundee; Gianfilippo Bertelli, Sussex Cancer Centre, Brighton, United Kingdom; Sibylle Loibl, Keyur Mehta, and Sabine Seiler, German Breast Group, Neu-Isenburg; Bernd Gerber, University Hospital..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianfilippo","family":"Bertelli","sequence":"additional","affiliation":[{"name":"Matteo Lambertini, Institut Jules Bordet, Universit\u00e9 Libre de Bruxelles, Brussels, Belgium; Halle C.F. Moore, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH; Robert C.F. Leonard, Imperial College, London; Richard A. Anderson, University of Edinburgh, Edinburgh; Douglas J.A. Adamson, Ninewells Hospital, Dundee; Gianfilippo Bertelli, Sussex Cancer Centre, Brighton, United Kingdom; Sibylle Loibl, Keyur Mehta, and Sabine Seiler, German Breast Group, Neu-Isenburg; Bernd Gerber, University Hospital..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabine","family":"Seiler","sequence":"additional","affiliation":[{"name":"Matteo Lambertini, Institut Jules Bordet, Universit\u00e9 Libre de Bruxelles, Brussels, Belgium; Halle C.F. Moore, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH; Robert C.F. Leonard, Imperial College, London; Richard A. Anderson, University of Edinburgh, Edinburgh; Douglas J.A. Adamson, Ninewells Hospital, Dundee; Gianfilippo Bertelli, Sussex Cancer Centre, Brighton, United Kingdom; Sibylle Loibl, Keyur Mehta, and Sabine Seiler, German Breast Group, Neu-Isenburg; Bernd Gerber, University Hospital..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcello","family":"Ceppi","sequence":"additional","affiliation":[{"name":"Matteo Lambertini, Institut Jules Bordet, Universit\u00e9 Libre de Bruxelles, Brussels, Belgium; Halle C.F. Moore, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH; Robert C.F. Leonard, Imperial College, London; Richard A. Anderson, University of Edinburgh, Edinburgh; Douglas J.A. Adamson, Ninewells Hospital, Dundee; Gianfilippo Bertelli, Sussex Cancer Centre, Brighton, United Kingdom; Sibylle Loibl, Keyur Mehta, and Sabine Seiler, German Breast Group, Neu-Isenburg; Bernd Gerber, University Hospital..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann H.","family":"Partridge","sequence":"additional","affiliation":[{"name":"Matteo Lambertini, Institut Jules Bordet, Universit\u00e9 Libre de Bruxelles, Brussels, Belgium; Halle C.F. Moore, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH; Robert C.F. Leonard, Imperial College, London; Richard A. Anderson, University of Edinburgh, Edinburgh; Douglas J.A. Adamson, Ninewells Hospital, Dundee; Gianfilippo Bertelli, Sussex Cancer Centre, Brighton, United Kingdom; Sibylle Loibl, Keyur Mehta, and Sabine Seiler, German Breast Group, Neu-Isenburg; Bernd Gerber, University Hospital..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucia","family":"Del Mastro","sequence":"additional","affiliation":[{"name":"Matteo Lambertini, Institut Jules Bordet, Universit\u00e9 Libre de Bruxelles, Brussels, Belgium; Halle C.F. Moore, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH; Robert C.F. Leonard, Imperial College, London; Richard A. Anderson, University of Edinburgh, Edinburgh; Douglas J.A. Adamson, Ninewells Hospital, Dundee; Gianfilippo Bertelli, Sussex Cancer Centre, Brighton, United Kingdom; Sibylle Loibl, Keyur Mehta, and Sabine Seiler, German Breast Group, Neu-Isenburg; Bernd Gerber, University Hospital..."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"233","reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/j.breast.2017.07.017"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1097\/CCO.0000000000000380"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djr541"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdt199"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2013.49.2678"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdv374"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdx184"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.b2535"},{"key":"B9","first-page":"269","volume":"306","author":"Del Mastro L","year":"2011","journal-title":"JAMA"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2015.17291"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1413204"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2010.32.5704"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2011.34.6890"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2007.12.044"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1007\/s10549-009-0313-5"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e31827374e2"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1007\/s12032-013-0667-8"},{"key":"B18","first-page":"59","volume":"35","author":"Karimi-Zarchi M","year":"2014","journal-title":"Eur J Gynaecol Oncol"},{"key":"B19","first-page":"15","volume":"19","author":"Sun J","year":"2011","journal-title":"China Disability Medicine"},{"key":"B21","first-page":"905","volume":"35","author":"Li M","year":"2008","journal-title":"Chinese Journal of Clinical Oncology"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.28738"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2013.52.8877"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2012.44.2285"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2016.10.034"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2015.64.8675"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2011.1019"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdx285"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2015.65.9573"}],"container-title":["Journal of Clinical Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/ascopubs.org\/doi\/pdfdirect\/10.1200\/JCO.2018.78.0858","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,5,29]],"date-time":"2022-05-29T04:21:35Z","timestamp":1653798095000},"score":1,"resource":{"primary":{"URL":"https:\/\/ascopubs.org\/doi\/10.1200\/JCO.2018.78.0858"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,7,1]]},"references-count":28,"journal-issue":{"issue":"19","published-print":{"date-parts":[[2018,7,1]]}},"alternative-id":["10.1200\/JCO.2018.78.0858"],"URL":"https:\/\/doi.org\/10.1200\/jco.2018.78.0858","relation":{},"ISSN":["0732-183X","1527-7755"],"issn-type":[{"value":"0732-183X","type":"print"},{"value":"1527-7755","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,7,1]]},"assertion":[{"value":"2018-05-02","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}