Absence of Conclusive Evidence for the Safety and Efficacy of Gonadotropin-Releasing Hormone Analogue Treatment in Protecting Against Chemotherapy-Induced Gonadal Injury

摘要

We read with interest the article by Oktay et al. , which purports that gonadotropin-releasing hormone (GnRH) analogue treatment for protection against chemotherapy-induced ovarian damage is ineffective.Though we firmly agree that randomized controlled trials are necessary to confirm GnRH analogue cotreatment efficacy, the preponderance of available evidence is very encouraging. A recent meta-analysis, inclusive of 320 patients from seven controlled studies, found GnRH agonist use during chemotherapy to be significantly associated with ovarian function preservation (relative risk, 1.7; 95% confidence interval, 1.4-2.2) .We would like to specifically address several comments in the review by Oktay et al. relevant to our published trial of leuprolide acetate in systemic lupus erythematosus (SLE) patients undergoing cyclophosphamide (CYC) therapy .