Yeah, the San Antonio, the 2025 San Antonio Breast Cancer Symposium, we presented the results of the PREFER study, Pregnancy and Fertility Study. This is a prospective multicenter study from my country, from Italy, in which 23 centers participated that aim to optimize oncofertility care in my country. So what we wanted to do with this study was to understand what the actual patient needs towards the available options for fertility preservation as well as for ovarian function preservation...
Yeah, the San Antonio, the 2025 San Antonio Breast Cancer Symposium, we presented the results of the PREFER study, Pregnancy and Fertility Study. This is a prospective multicenter study from my country, from Italy, in which 23 centers participated that aim to optimize oncofertility care in my country. So what we wanted to do with this study was to understand what the actual patient needs towards the available options for fertility preservation as well as for ovarian function preservation. So what we recommended was to perform a full oncofertility counseling with all newly diagnosed patients at the age of 45 years or less. In this patient, we will discuss the risk of developing chemotherapy-induced premature ovarian insufficiency and subsequent infertility. For those patients aged between 41 to 45 years, we only propose the use of a GnRH agonist during chemotherapy for ovarian function preservation. So not really for fertility reasons, but to reduce the risk of early menopause. In younger patients, people below 40 years of age or less, we propose both fertility preservation options, so cryopreservation procedures, as well as the use of a GnRH agonist for ovarian function preservation. So we included 746 patients, 533 were aged 40 years or less. And what we observed is that for the, I would say, older cohort, 41 to 45 years, there were 85% of the patients that still accepted the GnRH agonist during chemotherapy, meaning that ovarian function preservation is still relevant for the vast majority of patients. If you look at the young cohort, 40 years or less, we observed that 25%, one out of four, will undergo a cryopreservation procedure. So one out of four is interested in a fertility preservation procedure with almost 90% of the patients that will accept the use of a GnRH agonist during chemotherapy. So not only fertility preservation, but also ovarian function preservation is of relevance for this patient. And then the final probably most important take from this study is that when we compare the outcomes of patients that received or not controlled ovarian stimulation for oocyte cryopreservation, we did not observe any differences in disease-free survival nor in overall survival, including the cohort of patients with hormone receptor positive disease which is for oncologists, I think an important information that we should not be concerned in offering this option, even if we stimulate with hormones for a couple of weeks, newly diagnosed patients with breast cancer, because now we do have prospective data suggesting that there is no detrimental effect on patient outcomes. These data are, to our knowledge, the first multicenter prospective data in the field that add to the literature of many other retrospective studies or single center prospective studies that have shown the same finding that this short-term stimulation is not detrimental for patient prognosis. So hopefully these findings are going to be reassuring to improve oncofertility care in young patients with breast cancer.
