Evidence map›Paper›PMID 41745089›Full record

ReviewDiseases (Basel, Switzerland)2026

Reproductive Toxicity of Immune Checkpoint Inhibitors in Triple-Negative Breast Cancer: A Case Report with a Literature Review.

Cristina Tanase-Damian, Nicoleta Zenovia Antone, Diana Loreta Paun, Ioan Tanase, Patriciu Andrei Achimaș-Cadariu

Abstract readReview
In one paragraph

Review in Diseases (Basel, Switzerland), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Cristina Tanase-DamianFaculty of Medicine, "Iuliu Hatieganu" University of Medicine and Pharmacy, Victor Babes 8, 400347 Cluj Napoca, Romania.ORCID 0009-0002-0353-131X
Nicoleta Zenovia AntoneFaculty of Medicine, "Iuliu Hatieganu" University of Medicine and Pharmacy, Victor Babes 8, 400347 Cluj Napoca, Romania.ORCID 0000-0002-7497-5578
Diana Loreta PaunDepartment of Endocrinology, "Carol Davila" University of Medicine and Pharmacy, Eroii Sanitari 8, 050474 Bucharest, Romania.
Ioan TanaseDepartment of Surgery, "Carol Davila" University of Medicine and Pharmacy, Eroii Sanitari 8, 050474 Bucharest, Romania.ORCID 0000-0002-2625-344X
Patriciu Andrei Achimaș-CadariuFaculty of Medicine, "Iuliu Hatieganu" University of Medicine and Pharmacy, Victor Babes 8, 400347 Cluj Napoca, Romania.ORCID 0000-0001-9928-5883

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Triple-negative breast cancer (TNBC) is an aggressive malignancy that disproportionately affects young women. The integration of immune checkpoint inhibitors (ICIs) has significantly improved outcomes in both early-stage and metastatic TNBC, shifting attention toward long-term survivorship issues, particularly endocrine function and fertility. However, the reproductive safety profile of ICIs remains insufficiently characterized. This narrative review synthesizes current preclinical and clinical evidence on ICI-associated reproductive toxicity, focusing on both direct immune-mediated gonadal injury and indirect disruption of the hypothalamic-pituitary-gonadal axis. Experimental models consistently demonstrate immune cell infiltration of ovarian and testicular tissue, cytokine-driven inflammatory cascades, follicular atresia, impaired spermatogenesis, and altered steroidogenesis following PD-1/PD-L1 and CTLA-4 blockade. Emerging clinical data report cases of immune-related orchitis, azoospermia, testosterone deficiency, diminished ovarian reserve, and premature ovarian insufficiency. Secondary hypogonadism due to immune-mediated hypophysitis represents an additional and frequently underdiagnosed mechanism. We further discuss the oncofertility challenges faced by young patients with TNBC treated with chemoimmunotherapy, emphasizing the uncertainty of fertility risk stratification and the importance of early fertility counseling and individualized fertility preservation strategies. To illustrate the potential clinical impact, we present the case of a 34-year-old nulliparous woman who developed premature ovarian insufficiency two years after neoadjuvant chemoimmunotherapy including atezolizumab, despite ovarian suppression. In conclusion, while ICIs have transformed the therapeutic landscape of TNBC, their potential long-term impact on reproductive and endocrine health represents a clinically significant concern. A precautionary, multidisciplinary oncofertility approach and prospective clinical registries are essential to define the true incidence and mechanisms of ICI-associated reproductive toxicity.

Indexed as

fertilityhypogonadismimmune checkpoint inhibitorsoncofertilitypremature ovarian insufficiencyreproductive toxicitytriple-negative breast cancer

Identifiers

PMID41745089
PMCPMC12939086

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.