Antiblastic Treatment, for Solid Tumors, during Pregnancy: A Crucial Decision

Cancer is the second leading cause of death during the reproductive years complicating between 0.02% and 0.1% of pregnancies. The incidence is expected to rise with the increase in age of childbearing. The most common types of pregnancy-associated cancers are: cervical cancer, breast cancer, maligna...

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Veröffentlicht in:International journal of immunopathology and pharmacology 2012-04, Vol.25 (2_suppl), p.1-19
Hauptverfasser: Berretta, M, Di Francia, R, Lleshi, A, De Paoli, P, Li Volti, G, Bearz, A, Del Pup, L, Tirelli, U, Michieli, M
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container_end_page 19
container_issue 2_suppl
container_start_page 1
container_title International journal of immunopathology and pharmacology
container_volume 25
creator Berretta, M
Di Francia, R
Lleshi, A
De Paoli, P
Li Volti, G
Bearz, A
Del Pup, L
Tirelli, U
Michieli, M
description Cancer is the second leading cause of death during the reproductive years complicating between 0.02% and 0.1% of pregnancies. The incidence is expected to rise with the increase in age of childbearing. The most common types of pregnancy-associated cancers are: cervical cancer, breast cancer, malignant melanoma, Hodgkin's lymphoma, non-Hodgkin's lymphoma and ovarian cancer. The relatively rare occurrence of pregnancy-associated cancer precludes conducting large, prospective studies to examine diagnostic, management and outcome issues. The treatment of pregnancy-associated cancer is complex since it may be associated with adverse fatal effects. In pregnant patients diagnosed with cancer during the first trimester, treatment with multidrug anti-cancer chemotherapy is associated with an increased risk of congenital malformations, spontaneous abortions or fetal death, and therefore, should follow a strong recommendation for pregnancy termination. Second and third trimester exposure is not associated with teratogenic effect but increases the risk of intrauterine growth retardation and low birth weight. There are no sufficient data regarding the teratogenicity of most cytotoxic drugs. Almost all chemotherapeutic agents were found to be teratogenic in animals and for some drugs only experimental data exist. Moreover, no pharmacokinetic studies have been conducted in pregnant women receiving chemotherapy in order to understand whether pregnant women should be treated with different doses of chemotherapy. This article reviews the available data regarding the different aspects of the treatment of cancer during pregnancy.
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The incidence is expected to rise with the increase in age of childbearing. The most common types of pregnancy-associated cancers are: cervical cancer, breast cancer, malignant melanoma, Hodgkin's lymphoma, non-Hodgkin's lymphoma and ovarian cancer. The relatively rare occurrence of pregnancy-associated cancer precludes conducting large, prospective studies to examine diagnostic, management and outcome issues. The treatment of pregnancy-associated cancer is complex since it may be associated with adverse fatal effects. In pregnant patients diagnosed with cancer during the first trimester, treatment with multidrug anti-cancer chemotherapy is associated with an increased risk of congenital malformations, spontaneous abortions or fetal death, and therefore, should follow a strong recommendation for pregnancy termination. Second and third trimester exposure is not associated with teratogenic effect but increases the risk of intrauterine growth retardation and low birth weight. There are no sufficient data regarding the teratogenicity of most cytotoxic drugs. Almost all chemotherapeutic agents were found to be teratogenic in animals and for some drugs only experimental data exist. Moreover, no pharmacokinetic studies have been conducted in pregnant women receiving chemotherapy in order to understand whether pregnant women should be treated with different doses of chemotherapy. 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source Sage Journals GOLD Open Access 2024
subjects Antineoplastic Agents - adverse effects
Breast Neoplasms - drug therapy
Female
Humans
Lung Neoplasms - drug therapy
Ovarian Neoplasms - drug therapy
Pregnancy
Pregnancy Complications, Neoplastic - diagnosis
Pregnancy Complications, Neoplastic - drug therapy
Pregnancy Complications, Neoplastic - pathology
Stomach Neoplasms - drug therapy
Uterine Cervical Neoplasms - drug therapy
title Antiblastic Treatment, for Solid Tumors, during Pregnancy: A Crucial Decision
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