Gonadotoxicity of immunotherapy and targeted agents in patients with cancer and impact on subsequent pregnancies

In recent years, cancer treatment has been revolutionized by the introduction of many novel drugs, including immunotherapy and targeted agents, which have significantly improved the prognosis of patients with different solid tumors. While the role of traditional cytotoxic agents on fertility and rep...

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Published inHuman reproduction (Oxford) Vol. 40; no. 8; pp. 1452 - 1466
Main Authors Arecco, Luca, de Moura Leite, Luciana, Gentile, Gabriella, Jankovic, Kristina, Stana, Mihaela, Ottonello, Silvia, Scavone, Graziana, Spinaci, Stefano, Lambertini, Matteo
Format Journal Article
LanguageEnglish
Published England Oxford University Press 01.08.2025
Subjects
Animals
Antineoplastic Agents - adverse effects
Antineoplastic Agents - therapeutic use
Female
Fertility - drug effects
Fertility Preservation - methods
Humans
Immunotherapy - adverse effects
Male
Mini-Review
Molecular Targeted Therapy - adverse effects
Neoplasms - drug therapy
Neoplasms - therapy
Pregnancy
cancer treatments
gonadotoxicity
assisted reproduction
counseling
female infertility
immunotherapy
targeted agents
ovarian reserve
young patients
male infertility
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Abstract In recent years, cancer treatment has been revolutionized by the introduction of many novel drugs, including immunotherapy and targeted agents, which have significantly improved the prognosis of patients with different solid tumors. While the role of traditional cytotoxic agents on fertility and reproductive health of patients with cancer is currently well established, the impact of novel treatments remains an unmet medical need and a subject of concern. Limited clinical evidence exists to date on the potential gonadotoxicity of targeted agents and immunotherapy. However, in preclinical male and female animal models, several new treatments have demonstrated the potential to affect reproductive capacity. Hence, the possible impact of these treatments on patients’ reproductive potential should be urgently addressed. This work aims to review the most recent evidence regarding the gonadotoxicity of immunotherapy and novel targeted agents from the mechanisms of action of these treatments to the preclinical and clinical available data, as well as the implications on chances and risks of subsequent pregnancies. The final aim is to provide a useful tool to both physicians and patients for an informed decision-making process regarding fertility preservation and family planning before and after exposure to the new anticancer treatments.
AbstractList In recent years, cancer treatment has been revolutionized by the introduction of many novel drugs, including immunotherapy and targeted agents, which have significantly improved the prognosis of patients with different solid tumors. While the role of traditional cytotoxic agents on fertility and reproductive health of patients with cancer is currently well established, the impact of novel treatments remains an unmet medical need and a subject of concern. Limited clinical evidence exists to date on the potential gonadotoxicity of targeted agents and immunotherapy. However, in preclinical male and female animal models, several new treatments have demonstrated the potential to affect reproductive capacity. Hence, the possible impact of these treatments on patients' reproductive potential should be urgently addressed. This work aims to review the most recent evidence regarding the gonadotoxicity of immunotherapy and novel targeted agents from the mechanisms of action of these treatments to the preclinical and clinical available data, as well as the implications on chances and risks of subsequent pregnancies. The final aim is to provide a useful tool to both physicians and patients for an informed decision-making process regarding fertility preservation and family planning before and after exposure to the new anticancer treatments.In recent years, cancer treatment has been revolutionized by the introduction of many novel drugs, including immunotherapy and targeted agents, which have significantly improved the prognosis of patients with different solid tumors. While the role of traditional cytotoxic agents on fertility and reproductive health of patients with cancer is currently well established, the impact of novel treatments remains an unmet medical need and a subject of concern. Limited clinical evidence exists to date on the potential gonadotoxicity of targeted agents and immunotherapy. However, in preclinical male and female animal models, several new treatments have demonstrated the potential to affect reproductive capacity. Hence, the possible impact of these treatments on patients' reproductive potential should be urgently addressed. This work aims to review the most recent evidence regarding the gonadotoxicity of immunotherapy and novel targeted agents from the mechanisms of action of these treatments to the preclinical and clinical available data, as well as the implications on chances and risks of subsequent pregnancies. The final aim is to provide a useful tool to both physicians and patients for an informed decision-making process regarding fertility preservation and family planning before and after exposure to the new anticancer treatments.
In recent years, cancer treatment has been revolutionized by the introduction of many novel drugs, including immunotherapy and targeted agents, which have significantly improved the prognosis of patients with different solid tumors. While the role of traditional cytotoxic agents on fertility and reproductive health of patients with cancer is currently well established, the impact of novel treatments remains an unmet medical need and a subject of concern. Limited clinical evidence exists to date on the potential gonadotoxicity of targeted agents and immunotherapy. However, in preclinical male and female animal models, several new treatments have demonstrated the potential to affect reproductive capacity. Hence, the possible impact of these treatments on patients' reproductive potential should be urgently addressed. This work aims to review the most recent evidence regarding the gonadotoxicity of immunotherapy and novel targeted agents from the mechanisms of action of these treatments to the preclinical and clinical available data, as well as the implications on chances and risks of subsequent pregnancies. The final aim is to provide a useful tool to both physicians and patients for an informed decision-making process regarding fertility preservation and family planning before and after exposure to the new anticancer treatments.
In recent years, cancer treatment has been revolutionized by the introduction of many novel drugs, including immunotherapy and targeted agents, which have significantly improved the prognosis of patients with different solid tumors. While the role of traditional cytotoxic agents on fertility and reproductive health of patients with cancer is currently well established, the impact of novel treatments remains an unmet medical need and a subject of concern. Limited clinical evidence exists to date on the potential gonadotoxicity of targeted agents and immunotherapy. However, in preclinical male and female animal models, several new treatments have demonstrated the potential to affect reproductive capacity. Hence, the possible impact of these treatments on patients’ reproductive potential should be urgently addressed. This work aims to review the most recent evidence regarding the gonadotoxicity of immunotherapy and novel targeted agents from the mechanisms of action of these treatments to the preclinical and clinical available data, as well as the implications on chances and risks of subsequent pregnancies. The final aim is to provide a useful tool to both physicians and patients for an informed decision-making process regarding fertility preservation and family planning before and after exposure to the new anticancer treatments. Classification and main gonadotoxic effect of novel anticancer agents on females and males. Created in BioRender ( https://BioRender.com ). The original figure is available in BioRender ( https://BioRender.com/w65w494 ).
Author Lambertini, Matteo
Arecco, Luca
Stana, Mihaela
Spinaci, Stefano
Scavone, Graziana
de Moura Leite, Luciana
Ottonello, Silvia
Gentile, Gabriella
Jankovic, Kristina
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Keywords cancer treatments
gonadotoxicity
assisted reproduction
counseling
female infertility
immunotherapy
targeted agents
ovarian reserve
young patients
male infertility
Language English
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The Author(s) 2025. Published by Oxford University Press on behalf of European Society of Human Reproduction and Embryology.
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Snippet In recent years, cancer treatment has been revolutionized by the introduction of many novel drugs, including immunotherapy and targeted agents, which have...
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SubjectTerms Animals
Antineoplastic Agents - adverse effects
Antineoplastic Agents - therapeutic use
Female
Fertility - drug effects
Fertility Preservation - methods
Humans
Immunotherapy - adverse effects
Male
Mini-Review
Molecular Targeted Therapy - adverse effects
Neoplasms - drug therapy
Neoplasms - therapy
Pregnancy
Title Gonadotoxicity of immunotherapy and targeted agents in patients with cancer and impact on subsequent pregnancies
URI https://www.ncbi.nlm.nih.gov/pubmed/40482082
https://www.proquest.com/docview/3216695061
https://pubmed.ncbi.nlm.nih.gov/PMC12314150
Volume 40
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