Abstract: PD13-10
Sources of Funding: None

Introduction

The use of Tyrosine Kinase Inhibitors (TKI) in men with certain malignancies has in many cases improved the course of illness from rapidly fatal to a chronic disease requiring long-term treatment. However, very little has been published on TKI effects on male fertility despite the potential for significant risk to fertility. Many major organizations have guidelines advocating fertility preservation (FP) for all patients at risk of impaired fertility from cancer treatment, yet it is unclear how often men receiving TKI are counseled on the fertility risks of their oncologic treatments and the need for FP. We sought to identify potential barriers to accessing oncofertility care, assess baseline understanding of treatment-related infertility, and characterize reproductive expectations of men receiving TKI treatment.

Methods

A retrospective cohort of men receiving TKI at UCSF completed a single detailed questionnaire. Cancer history, consultation with treating physician about the possible effects on fertility, obstacles to fertility preservation methods and satisfaction with treatment decisions were addressed.

Results

Fifty-one patients receiving TKI participated in the study. The mean age was 46 years (range 21-72). Thirty-one (61%) had chronic myelogenous leukemia and 26 (51%) had received prior treatment for cancer (11 surgery, 12 chemotherapy, 3 radiation). While 18 (36%) said they would like to have children in the future and 24 (46%) had some degree of concern that their cancer treatment might affect their fertility, 26 (51%) were not given any information about the fertility risks of TKI by their medical team, 30 (59%) were not able to discuss possible ways to protect their fertility, and 39 (76%) did not have the opportunity to discuss protecting their testicles from cancer treatments. Furthermore, 32 (63%) felt they had encountered some barrier to fertility care prior to receiving their cancer treatment, including 11 (22%) who were not provided a referral to a fertility specialist, and 14 (27%) who did not understand that the cancer treatment might affect their fertility.

Conclusions

Nearly half of the patients surveyed worried about the reproductive risks of TKI, and most felt they had not received enough information about these risks. Furthermore, the majority of men experienced barriers to oncofertility care. These findings highlight the need for medical providers to take a proactive approach to discuss potential fertility risks in men on TKI.

Funding

None