Informing the gravid void: A population-based study of live birth rates after oncologic immunotherapy in reproductive age women.
Notice bibliographique
Résumé
e14654 Background: Immunotherapy is a new standard oncologic treatment modality in nearly every organ system, however fertility sequalae are yet to be defined. Oncologic immunotherapy has been proposed by various theoretical mechanisms to decrease female fertility in animal models. Only case reports of pregnancies after immunotherapy exist in the literature. This study sought to describe real world population based-data on the live-birth rate after oncologic immunotherapy. Methods: This was a population-based retrospective cohort study of female patients between the age of 15 and 49 diagnosed with melanoma, non-small cell lung cancer, urothelial bladder and kidney cancer, or head and neck cancer, between 2012 and 2021 in Ontario, Canada. Primary exposure was oncologic immunotherapy with PD-L1 inhibitors, PD-1 inhibitors and CTLA inhibitors, and patients were followed from date of diagnosis for a minimum of 1 year up to age 50, hysterectomy, pelvic radiation, death or end of the follow up period (2022). Descriptive statistics were used to calculate the rate of live births per reproductive age woman years and rate of reproductive events per reproductive age woman years. Results: 5, 796 women met inclusion criteria of whom 333 (5.7%) received oncologic immunotherapy. The mean age of those who did and did not receive oncologic immunotherapy was not different (40.4 years (SD 6.7) vs 39.9 years (SD 7.7), p = 0.07). Approximately half of the women in both groups were diagnosed with melanoma (55.0% and 54.2%). Advanced stage at diagnosis was significantly more common in the group treated with oncologic immunotherapy (p < 0.0001). 297 (89.2%) women received PD-1 inhibitors, 118 (35.4%) CTLA inhibitors and 22 (6.6%) PD-L1 inhibitors. 13 (3.9%) patients who received oncologic immunotherapy had at least one live delivery, while 451 (8.3%) patients who did not receive oncologic immunotherapy had at least one live delivery. There was no statistical difference in the number of still births or abortions between the groups (p = 0.33 and p = 0.89). The rate of live-births after cancer diagnosis per 1000 reproductive age woman years was 18.5 (95%CI 11.2-30.7) in patients who received oncologic immunotherapy and 27.9 (95%CI 25.7-30.2) in patients who did not receive oncologic immunotherapy. The median time from first oncologic immunotherapy to first live birth was 2.02 years (range 1.78-2.26 years). The rate of reproductive events after cancer diagnosis per 1000 reproductive age woman years was 28.4 (95%CI 18.9-42.7) and 34.7 (95%CI 32.3-37.3) respectively. Conclusions: Women are having live births after oncologic immunotherapy, and preliminary real world population-based data suggests their rate of live births and reproductive events may be similar to that of women diagnosed with cancer who receive oncologic treatment not including oncologic immunotherapy.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,004 | 0,003 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».