Fertility preservation in pediatric solid tumors: A report from the Children's Oncology Group

Treatment for childhood solid tumors may lead to an increased risk for gonadal dysfunction/infertility. Discussion of risk should occur at diagnosis, any changes in therapy, and during survivorship. Gonadotoxic therapies were ed from 32 Children's Oncology Group (COG) phase III, frontline solid...

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Bibliographic Details
Published in:Pediatric blood & cancer 2024-06, Vol.71 (6), p.e30960-n/a
Main Authors: Bjornard, Kari, Close, Allison, Burns, Karen, Chavez, Josuah, Chow, Eric J., Meacham, Lillian R.
Format: Article
Language:English
Subjects:
Cancer therapies
Children
Fertility
fertility preservation
Infertility
oncofertility
Oncology
Pediatrics
Reproductive health
Risk assessment
Solid tumors
Survival
Tumors
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Summary:Treatment for childhood solid tumors may lead to an increased risk for gonadal dysfunction/infertility. Discussion of risk should occur at diagnosis, any changes in therapy, and during survivorship. Gonadotoxic therapies were ed from 32 Children's Oncology Group (COG) phase III, frontline solid tumor protocols, in use from 2000 to 2022. Risk for gonadal dysfunction/infertility was assessed based on gonadotoxic therapies, sex, and pubertal status and assigned as minimal, significant, and high following the Oncofertility Consortium Pediatric Initiative Network (PIN) risk stratification. Most protocols (65.6%, 21/32) contained at least one therapeutic arm with a high level of increased risk. Solid tumor therapies present challenges in risk stratification due to response‐adjusted therapy and the need to account for radiation field in the risk assessment. This guide hopes to serve as a tool to assist in standardizing gonadotoxic risk assessments across disciplines and improve referral for fertility services and reproductive health counseling for patients receiving COG‐based solid tumor therapy. Internationally, many solid tumor therapies follow similar paradigms to COG studies, and risk stratifications may be generalizable to similar styles of therapy. In addition, this model may be applied to other international groups with the goal of standardizing fertility assessments.
ISSN:1545-5009
1545-5017
DOI:10.1002/pbc.30960