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 |
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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. This article reviews the available data regarding the different aspects of the treatment of cancer during pregnancy.</description><identifier>ISSN: 0394-6320</identifier><identifier>EISSN: 2058-7384</identifier><identifier>DOI: 10.1177/03946320120250S201</identifier><identifier>PMID: 23092516</identifier><language>eng</language><publisher>London, England: SAGE Publications</publisher><subject>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</subject><ispartof>International journal of immunopathology and pharmacology, 2012-04, Vol.25 (2_suppl), p.1-19</ispartof><rights>2012 SAGE Publications</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c387t-86a49e353a1df35ef6cc162807e916a4c2b79765fd787fada30d2cebeadc03cf3</citedby><cites>FETCH-LOGICAL-c387t-86a49e353a1df35ef6cc162807e916a4c2b79765fd787fada30d2cebeadc03cf3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/03946320120250S201$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/03946320120250S201$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,776,780,21945,27830,27901,27902,44921,45309</link.rule.ids><linktorsrc>$$Uhttps://journals.sagepub.com/doi/full/10.1177/03946320120250S201?utm_source=summon&utm_medium=discovery-provider$$EView_record_in_SAGE_Publications$$FView_record_in_$$GSAGE_Publications</linktorsrc><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23092516$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Berretta, M</creatorcontrib><creatorcontrib>Di Francia, R</creatorcontrib><creatorcontrib>Lleshi, A</creatorcontrib><creatorcontrib>De Paoli, P</creatorcontrib><creatorcontrib>Li Volti, G</creatorcontrib><creatorcontrib>Bearz, A</creatorcontrib><creatorcontrib>Del Pup, L</creatorcontrib><creatorcontrib>Tirelli, U</creatorcontrib><creatorcontrib>Michieli, M</creatorcontrib><title>Antiblastic Treatment, for Solid Tumors, during Pregnancy: A Crucial Decision</title><title>International journal of immunopathology and pharmacology</title><addtitle>Int J Immunopathol Pharmacol</addtitle><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.</description><subject>Antineoplastic Agents - adverse effects</subject><subject>Breast Neoplasms - drug therapy</subject><subject>Female</subject><subject>Humans</subject><subject>Lung Neoplasms - drug therapy</subject><subject>Ovarian Neoplasms - drug therapy</subject><subject>Pregnancy</subject><subject>Pregnancy Complications, Neoplastic - diagnosis</subject><subject>Pregnancy Complications, Neoplastic - drug therapy</subject><subject>Pregnancy Complications, Neoplastic - pathology</subject><subject>Stomach Neoplasms - drug therapy</subject><subject>Uterine Cervical Neoplasms - drug therapy</subject><issn>0394-6320</issn><issn>2058-7384</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kMtKAzEUhoMottS-gAvJ0kXH5tJMMu5KvUJFoXU9ZHIpKTNJTWYWfXuntLoRXJ0D5_t_OB8A1xjdYcz5FNFillOCMEGEoVW_nIEhQUxknIrZORgegOxADMA4pS1CCCM6YwJfggGhqCAM50PwNvetq2qZWqfgOhrZNsa3E2hDhKtQOw3XXRNimkDdRec38COajZde7e_hHC5ip5ys4YNRLrngr8CFlXUy49Mcgc-nx_XiJVu-P78u5stMUcHbTORyVhjKqMTaUmZsrhTOiUDcFLi_KVLxgufMai64lVpSpIkylZFaIaosHYHbY-8uhq_OpLZsXFKmrqU3oUslJpxSzvJC9Cg5oiqGlKKx5S66RsZ9iVF5MFn-NdmHbk79XdUY_Rv58dYD0yOQ5MaU29BF3__7X-U3eb161g</recordid><startdate>201204</startdate><enddate>201204</enddate><creator>Berretta, M</creator><creator>Di Francia, R</creator><creator>Lleshi, A</creator><creator>De Paoli, P</creator><creator>Li Volti, G</creator><creator>Bearz, A</creator><creator>Del Pup, L</creator><creator>Tirelli, U</creator><creator>Michieli, M</creator><general>SAGE Publications</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201204</creationdate><title>Antiblastic Treatment, for Solid Tumors, during Pregnancy: A Crucial Decision</title><author>Berretta, M ; Di Francia, R ; Lleshi, A ; De Paoli, P ; Li Volti, G ; Bearz, A ; Del Pup, L ; Tirelli, U ; Michieli, M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c387t-86a49e353a1df35ef6cc162807e916a4c2b79765fd787fada30d2cebeadc03cf3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Antineoplastic Agents - adverse effects</topic><topic>Breast Neoplasms - drug therapy</topic><topic>Female</topic><topic>Humans</topic><topic>Lung Neoplasms - drug therapy</topic><topic>Ovarian Neoplasms - drug therapy</topic><topic>Pregnancy</topic><topic>Pregnancy Complications, Neoplastic - diagnosis</topic><topic>Pregnancy Complications, Neoplastic - drug therapy</topic><topic>Pregnancy Complications, Neoplastic - pathology</topic><topic>Stomach Neoplasms - drug therapy</topic><topic>Uterine Cervical Neoplasms - drug therapy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Berretta, M</creatorcontrib><creatorcontrib>Di Francia, R</creatorcontrib><creatorcontrib>Lleshi, A</creatorcontrib><creatorcontrib>De Paoli, P</creatorcontrib><creatorcontrib>Li Volti, G</creatorcontrib><creatorcontrib>Bearz, A</creatorcontrib><creatorcontrib>Del Pup, L</creatorcontrib><creatorcontrib>Tirelli, U</creatorcontrib><creatorcontrib>Michieli, M</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>International journal of immunopathology and pharmacology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext_linktorsrc</fulltext></delivery><addata><au>Berretta, M</au><au>Di Francia, R</au><au>Lleshi, A</au><au>De Paoli, P</au><au>Li Volti, G</au><au>Bearz, A</au><au>Del Pup, L</au><au>Tirelli, U</au><au>Michieli, M</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Antiblastic Treatment, for Solid Tumors, during Pregnancy: A Crucial Decision</atitle><jtitle>International journal of immunopathology and pharmacology</jtitle><addtitle>Int J Immunopathol Pharmacol</addtitle><date>2012-04</date><risdate>2012</risdate><volume>25</volume><issue>2_suppl</issue><spage>1</spage><epage>19</epage><pages>1-19</pages><issn>0394-6320</issn><eissn>2058-7384</eissn><abstract>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. 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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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