AMH Predicts Benefit of Chemo + Endocrine Therapy in Under 55s With Breast Cancer

Invasive disease-free survival superior with CET versus ET among those with anti-Müllerian hormone ≥10 pg/mL
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WEDNESDAY, Aug. 12, 2026 (HealthDay News) -- Anti-Müllerian hormone (AMH) appears to predict the benefit of chemotherapy plus endocrine therapy (CET) versus ET alone in premenopausal women younger than 55 years with hormone receptor-positive/human epidermal growth factor receptor 2-negative breast cancer with a recurrence score (RS) ≤25, according to a study published online July 24 in the Annals of Oncology.

Kevin Kalinsky, M.D., from the Winship Cancer Institute at Emory University in Atlanta, and colleagues examined hormones associated with ovarian reserve to refine the prediction of CET benefit in patients with hormone receptor-positive/human epidermal growth factor receptor 2-negative breast cancer with RS ≤25. Pretreatment serum estradiol, progesterone, follicle-stimulating hormone (FSH), luteinizing hormone (LH), AMH, and inhibin B (INHB) were assessed in 1,556 participants younger than 55 years.

The researchers found that baseline estradiol, progesterone, LH, and FSH did not predict CET benefit. There was a significant interaction for AMH ≥10 pg/mL with CET benefit for invasive disease-free survival (IDFS). IDFS was superior with CET versus ET alone in 64 percent of women with AMH ≥10 pg/mL (cutoff for normal ovarian reserve), while CET was not beneficial for the 36 percent with low ovarian reserve (<10 pg/mL). A similar pattern of results for AMH was seen for distant relapse-free survival. Ultrasensitive INHB (pg/mL range) was also predictive of CET benefit.

"These results move us closer to precision medicine," Kalinsky said in a statement. "Rather than making treatment decisions based solely on age, we may soon be able to use objective biological measurements of menopausal status to identify who truly needs chemotherapy and who does not."

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