Testicular function after non‐cytotoxic and immunotherapy drug treatment

Abstract

AbstractBackgroundThe effects of novel non‐cytotoxic and immunotherapy drugs for cancer treatment on human testicular function have not been studied systematically.ObjectivesThe present study aimed to characterize effects of non‐cytotoxic and immunotherapy drugs in patients with cancers who had not been previously treated with gonadotoxic chemo‐ or radiotherapy.Materials and methodsThis study involved 34 men, not previously treated with gonadotoxic regimens, in a mixed longitudinal (Cohort 1: 19 men about to start and approximately 1 year on non‐cytotoxic and immunotherapy treatment) and cross‐sectional (Cohort 2: 15 men already on non‐cytotoxic and immunotherapy treatment) study using data modeling to estimate within‐person time‐course changes in testicular exocrine and endocrine functions. Cohort 1 provided 45 paired semen and blood samples (34 prior to and nine during treatment) and Cohort 2 provided 45 sets of samples (15 pre‐treatment, 30 on treatment), including six men in Cohort 2 who had pre‐treatment spermatozoa cryostorage prior to the study. Men on non‐cytotoxic and immunotherapy treatment had undergone a median of 33.5 months long‐term treatment.ResultsSpermatozoa output and concentration were reduced by about 50%, with corresponding increases in serum follicle‐stimulating hormone and decreases in serum inhibin B. Serum testosterone, luteinizing hormone, and sex hormone‐binding globulin were unaffected by non‐cytotoxic and immunotherapy treatment.ConclusionWithin limits of the present study of sample size and duration of on‐non‐cytotoxic and immunotherapy treatment, non‐cytotoxic and immunotherapy drugs have a modest effects on testicular exocrine function (sperm production) or its hormonal correlates (follicle‐stimulating hormone, inhibin B), with minimal impact on testicular endocrine (testosterone, luteinizing hormone) function.