ArticleCureus2026
Normal Ovarian Reserve During Long-Term Osimertinib Therapy in a Patient With Li-Fraumeni Syndrome: A Case Report and Literature Review.
Article in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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4 authors.
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Abstract
In contrast to the well-studied gonadotoxicity of traditional chemotherapy, data on the long-term effects of newer targeted molecular therapies on human ovarian reserves and fertility remain scarce. Here, we report the effect of osimertinib on ovarian reserve. Osimertinib is a third-generation, irreversible tyrosine kinase inhibitor that selectively targets epidermal growth factor receptor (EGFR)-mutant tumors and is used to treat EGFR-positive non-small cell lung cancer (NSCLC). We present a 30-year-old woman with a history of Li-Fraumeni syndrome (LFS), NSCLC, and a large fumarate hydratase-deficient uterine fibroid who was referred for fertility counseling and preservation while receiving maintenance osimertinib. Ovarian reserve was assessed using anti-Müllerian hormone (AMH) measurements and serial pelvic ultrasounds to determine the antral follicle count. Monitoring over 36 months of osimertinib therapy showed a normal ovarian reserve, as evidenced by normal AMH levels and a stable antral follicle count. We demonstrate a normal ovarian reserve in a patient receiving long-term osimertinib treatment. Despite a preserved ovarian reserve, patients on targeted molecular therapies for high-penetrance genetic cancers still face significant reproductive challenges. These challenges include the need for preimplantation genetic testing for monogenic disorders (PGT-M) to reduce the risk of transmitting cancer-predisposition gene mutations to their offspring and the consideration of a gestational carrier, as current guidelines prohibit pregnancy during targeted molecular therapy. Maintaining a normal ovarian reserve would allow the opportunity to delay in vitro fertilization (IVF) until a more optimal time, thereby improving reproductive planning for patients who already manage the burdens of hereditary cancer syndrome.
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