PRINCESS: Preservation of fertility and quality of life in women cured of childhood cancer in Belgium

PRINCESS, a clinical trial starting in Belgium in 2024, aims to evaluate the impact of chemotherapy and fertility preservation on ovarian function and future fertility in childhood cancer survivors aged 18 years and older.

In Belgium, an average of 429 children and adolescents (ages 0-17) are diagnosed with cancer each year (2017-2020). The overall 10-year survival rate for all childhood cancers combined has reached 85%, and focus is now shifting to the long-term impact on adults cured of childhood cancer.

For women cured of childhood cancer, the risk of infertility is a major concern, significantly affecting quality of life.

In girls, the effects of low and intermediate doses of chemotherapy on fertility are not yet clearly established. Before puberty, the only way to preserve fertility is by freezing the ovaries, although this technique may negatively impact long-term fertility. It is therefore important to better identify which girls may benefit from ovarian freezing, considering the risk-benefit balance of this technique and each individual's risk of developing infertility.

At the GIGA research laboratories, we are also working to develop new techniques for the early detection of ovarian failure in women who have been cured of childhood cancer.

PRINCESS is a multi-centre, translational, prospective, and interventional clinical trial with a case-control study design. We will collect clinical, biological, imaging, and genetic data, and we are collaborating with the B-STAT team to design and analyze the study data.

The main objective of the trial is to improve ovarian preservation and quality of life in childhood cancer survivors.

The trial is led by CHU de Liège, with Dr. Bianca David as the national coordinator. Three centers will participate: CHU de Liège, Cliniques Universitaires Saint-Luc, and Hôpital Universitaire des Enfants Reine-Fabiola. We expect to enroll around 170 patients and 170 controls. Additional centers may join at a later stage.

This study is taking place in Belgium thanks to the financial support of the Fondation Contre le Cancer (Grant OST 2022/2173, valid until the end of 2026).