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Miller D, Livingston JA, Park Y, Posey K, Godbole S, Skubitz K, Robinson SI, Agulnik M, Davis LE, Van Tine BA, Hirbe AC, Parkes A. Pregnancy outcomes related to the treatment of sarcomas with anthracyclines and/or ifosfamide during pregnancy. Cancer Med 2022; 11:3471-3478. [PMID: 35343652 PMCID: PMC9487868 DOI: 10.1002/cam4.4707] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 02/14/2022] [Accepted: 03/13/2022] [Indexed: 11/12/2022] Open
Abstract
Background Sarcomas are rare diagnoses but are seen with relative frequency in adolescents and young adults and thus can present in pregnancy. We sought to study the administration of anthracyclines and/or ifosfamide in pregnancy‐associated sarcomas. Patients and Methods We conducted a multi‐institutional retrospective study, identifying sarcoma patients who received anthracyclines and/or ifosfamide during pregnancy. Chart review identified variables related to demographics, cancer diagnosis, therapies, and outcome of the patient and fetus. Wilcoxon rank‐sum test compared two independent samples. Results We identified 13 patients at seven institutions with sarcoma who received anthracyclines and/or ifosfamide during pregnancy, including four bone sarcomas and nine soft tissue sarcomas diagnosed at a mean gestational age of 16.7 ± 5.9 weeks. Only nine patients had live births (9/13, 69.2%), with mean gestational age of 30.8 ± 3.8 weeks at delivery. The four patients with pregnancy loss all received both doxorubicin and ifosfamide, with chemotherapy initiated at 15.5 weeks as compared with 21.3 weeks for those patients with live births (p = 0.016). Conclusion In this multi‐institutional study of sarcoma chemotherapy regimens administered during pregnancy, we found a high rate of fetal demise that was seen only in patients receiving both doxorubicin and ifosfamide and statistically more likely with chemotherapy initiation earlier in the second trimester. While limited by a small sample size, our study represents the largest study of sarcoma patients that received anthracyclines and/or ifosfamide in pregnancy thus far reported and supports development of an international registry to study concerns raised by our study.
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Affiliation(s)
- Devon Miller
- University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin, USA
| | | | - Yeonhee Park
- Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | | | - Sonia Godbole
- Washington University in St. Louis School of Medicine, St. Louis, Missouri, USA
| | - Keith Skubitz
- University of Minnesota, Minneapolis, Minnesota, USA
| | | | | | - Lara E Davis
- Oregon Health & Science University, Portland, Oregon, USA
| | - Brian A Van Tine
- Washington University in St. Louis School of Medicine, St. Louis, Missouri, USA
| | - Angela C Hirbe
- Washington University in St. Louis School of Medicine, St. Louis, Missouri, USA
| | - Amanda Parkes
- University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin, USA
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2
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Xu H, Tan S. Diagnosis and Treatment of Renal Cell Carcinoma During Pregnancy. Cancer Manag Res 2022; 13:9423-9428. [PMID: 35002320 PMCID: PMC8721013 DOI: 10.2147/cmar.s345309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 12/23/2021] [Indexed: 11/23/2022] Open
Abstract
Renal cell carcinoma during pregnancy is extremely rare, but it is the commonest urological malignancy reported in pregnancy. Currently, no uniform domestic or international diagnostic or treatment criteria exist for these patients, so their diagnosis and treatment are challenging for urologists. The health and reproductive needs of these patients have improved in recent years because of the continuous development of medical technology. This article reviews the epidemiology, risk factors, diagnosis, treatment, and prognosis of renal cell carcinoma during pregnancy.
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Affiliation(s)
- Hainan Xu
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, People's Republic of China
| | - Shutao Tan
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, People's Republic of China
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3
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Pei Y, Gou Y, Li N, Yang X, Han X, Huiling L. Efficacy and Safety of Platinum-Based Chemotherapy for Ovarian Cancer During Pregnancy: A Systematic Review and Meta-Analysis. Oncol Ther 2021; 10:55-73. [PMID: 34865206 PMCID: PMC9098723 DOI: 10.1007/s40487-021-00179-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 11/17/2021] [Indexed: 11/25/2022] Open
Abstract
Introduction Based on the available data on ovarian cancer during pregnancy, we performed a review and meta-analysis to evaluate the efficacy and safety of platinum-based chemotherapy against ovarian cancer during pregnancy. Methods We systematically searched three databases including the PubMed, Embase, and Cochrane Library databases for articles published from January 1986 to December 2020 using the following terms: “ovarian tumors OR ovarian carcinoma OR adnexal masses OR ovarian cancer” AND “pregnancy” AND “chemotherapy.” Two authors (Yaping Pei and Yuanfeng Gou) independently searched the literature and extracted data from each eligible study. The outcome measures were overall survival (OS) and progression-free survival (PFS). The OS and PFS of all patients were estimated by Kaplan–Meier survival curves and log-rank tests. Results A total of 43 studies including 55 cases of ovarian cancer during pregnancy were selected. Forty-eight patients were comprehensively staged using the International Federation of Gynecology and Obstetrics (FIGO) staging system. Twenty-six of the 48 patients (54.17%) were diagnosed with early-stage disease, while the remaining had advanced stages (II, III, and IV). The mean age at diagnosis was 29.31 years. The majority of patients in this meta-analysis were diagnosed at a mean gestational age of 16.05 weeks. The mean GA at chemotherapy administration was 17.42 weeks. Overall, 55 women gave birth to 56 newborns, including a pair of twins. At the end of follow-up (median 10 months, range 0–73 months), all the children were healthy, except for one child who died 5 days after delivery due to a congenital abnormality. During 2–204 months of follow-up, there were five cases of recurrence, with no evidence of recurrence in the remaining cases. Unfortunately, one patient died 29 months after diagnosis. Neither median overall survival nor median progression-free survival was obtained. Conclusion Platinum-based chemotherapy may be a good choice for pregnant women with ovarian cancer who want to continue their pregnancy. Supplementary Information The online version contains supplementary material available at 10.1007/s40487-021-00179-9.
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Affiliation(s)
- Yaping Pei
- Department of Clinical Medicine, Gansu University of Traditional Chinese Medicine, Lanzhou, 730000, China
| | - Yuanfeng Gou
- Department of Clinical Medicine, Gansu University of Traditional Chinese Medicine, Lanzhou, 730000, China
| | - Na Li
- Department of Clinical Medicine, Gansu University of Traditional Chinese Medicine, Lanzhou, 730000, China
| | - Xiaojuan Yang
- Department of Clinical Medicine, Gansu University of Traditional Chinese Medicine, Lanzhou, 730000, China
| | - Xue Han
- Department of Gynecology and Obstetrics, Gansu Provincial Hospital, Donggang West Road, Lanzhou, 730000, China
| | - Liu Huiling
- Department of Gynecology and Obstetrics, Gansu Provincial Hospital, Donggang West Road, Lanzhou, 730000, China.
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4
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Pini A, Fazi C, Nardini P, Calvani M, Fabbri S, Guerrini A, Forni G, La Marca G, Rosa AC, Filippi L. Effect of Beta 3 Adrenoreceptor Modulation on Patency of the Ductus Arteriosus. Cells 2020; 9:cells9122625. [PMID: 33297453 PMCID: PMC7762377 DOI: 10.3390/cells9122625] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 12/02/2020] [Accepted: 12/06/2020] [Indexed: 01/09/2023] Open
Abstract
β3-adrenoreceptor (β3-AR), a G-protein coupled receptor, has peculiar regulatory properties in response to oxygen and widespread localization. β3-AR is expressed in the most frequent neoplasms, also occurring in pregnant women, and its blockade reduces tumor growth, indicating β3-AR-blockers as a promising alternative to antineoplastic drugs during pregnancy. However, β3-AR involvement in prenatal morphogenesis and the consequences of its blockade for the fetus remain unknown. In this study, after the demonstrated expression of β3-AR in endothelial and smooth muscle cells of ductus arteriosus (DA), C57BL/6 pregnant mice were acutely treated at 18.5 of gestational day (GD) with indomethacin or with the selective β3-AR antagonist SR59230A, or chronically exposed to SR59230A from 15.5 to 18.5 GD. Six hours after the last treatment, fetuses were collected. Furthermore, newborn mice were treated straight after birth with BRL37344, a β3-AR agonist, and sacrificed after 7 h. SR59230A, at the doses demonstrated effective in reducing cancer progression (10 and 20 mg/kg) in acute and chronic mode, did not induce fetal DA constriction and did not impair the DA ability to close after birth, whereas at the highest dose (40 mg/kg), it was shown to cause DA constriction and preterm-delivery. BRL37344 administered immediately after birth did not alter the physiological DA closure.
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Affiliation(s)
- Alessandro Pini
- Department of Experimental and Clinical Medicine, University of Florence, 50139 Florence, Italy;
- Correspondence: (A.P.); (L.F.); Tel.: +39-0552758155 (A.P.); +39-050993677 (L.F)
| | - Camilla Fazi
- Department of Health Sciences, University of Florence, 50139 Florence, Italy;
| | - Patrizia Nardini
- Department of Experimental and Clinical Medicine, University of Florence, 50139 Florence, Italy;
| | - Maura Calvani
- Department of Paediatric Haematology-Oncology, A. Meyer University Children’s Hospital, 50139 Florence, Italy;
| | - Sergio Fabbri
- Department of Neuroscience, Psychology, Drug Research and Child Health, Section of Pharmacology and Toxicology, University of Florence, 50139 Florence, Italy;
| | - Alessandro Guerrini
- Department of Veterinary Medical Sciences, University of Bologna, 40064 Ozzano dell’Emilia, Italy;
| | - Giulia Forni
- Department of Neuroscience, Psychology, Drug Research and Child Health, Section of Pediatric Neurosciences, “A. Meyer” University Children’s Hospital, 50139 Florence, Italy; (G.F.); (G.L.M.)
| | - Giancarlo La Marca
- Department of Neuroscience, Psychology, Drug Research and Child Health, Section of Pediatric Neurosciences, “A. Meyer” University Children’s Hospital, 50139 Florence, Italy; (G.F.); (G.L.M.)
| | - Arianna Carolina Rosa
- Department of Scienza e Tecnologia del Farmaco, University of Turin, 10125 Turin, Italy;
| | - Luca Filippi
- Division of Neonatology and NICU, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
- Correspondence: (A.P.); (L.F.); Tel.: +39-0552758155 (A.P.); +39-050993677 (L.F)
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5
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Wang L, Huang S, Sheng X, Ren C, Wang Q, Yang L, Zhao S, Xu T, Ma X, Guo R, Sun P, Lin Y, Li Y, Wang J, Wang Y. Malignant Ovarian Tumors During Pregnancy: A Multicenter Retrospective Analysis. Cancer Manag Res 2020; 12:10841-10848. [PMID: 33149689 PMCID: PMC7605603 DOI: 10.2147/cmar.s271806] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 10/06/2020] [Indexed: 01/05/2023] Open
Abstract
Purpose The aim of this study was to investigate the clinical characteristics and management of malignant ovarian tumors during pregnancy, as well as the feto-maternal outcomes and analyze the influential factors on the pregnancy outcomes. Patients and Methods Eighty-five patients with ovarian malignancies during pregnancy treated at 12 tertiary hospitals between 2009 and 2019 were analyzed in this study. The clinical features, histopathological characteristics, clinical management, and maternal and perinatal outcomes were retrospectively analyzed. The clinical features and managements were compared between abortion group and live birth group. Results The following diagnoses were made: 41 (48.24%) patients with borderline ovarian tumors, 18 (21.18%) patients with epithelial ovarian cancers, 17 (20.00%) patients with non-epithelial ovarian malignancies and 9 (10.59%) patients with metastatic ovarian tumors. Thirty-six (42.45%) patients underwent conservative surgical treatment. Thirty-four (40.00%) patients opted for fertility-sparing surgery, and fifteen (17.56%) patients received radical surgery. Chemotherapy was administered to 32.94% of the patients. The proportion of ovarian malignancies diagnosed in the first trimester in the abortion group was higher than that in the live birth group (P<0.05). However, tumor diameter, reproductive history, stage and surgical indications showed no significant differences between groups. A total of 67 live babies were recorded in this study, including 19 premature babies and 1 full-term newborn who died of respiratory distress. All of the BOTs were diagnosed with stage I, among whom 38 (92.68%) patients exhibited disease-free survival. Twenty-eight ovarian cancers were in stage I–II and 26 of them had disease-free survival with the longest follow-up time of 10 years. Five of the sixteen patients in advanced stage (stage III–IV) died, four of whom had metastatic tumors. Conclusion Pregnant women with early-stage malignant ovarian tumors appear to have favorable outcomes. Conservative surgery is acceptable for early-stage borderline ovarian tumors during pregnancy. The gestational age of ovarian malignancy detection is key for pregnancy outcomes.
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Affiliation(s)
- Liya Wang
- Department of Gynecologic Oncology, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Municipal Key Clinical Specialty, Shanghai Key Laboratory of Embryo Original Disease, Shanghai, 200030, People's Republic of China
| | - Shenjiao Huang
- Department of Obstetrics and Gynecology, Guangzhou Women and Children's Medical Centre, Guangzhou 510623, People's Republic of China
| | - Xiujie Sheng
- Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Guangzhou Medical University, Key Laboratory of Major Obstetric Diseases of Guangdong Province, Guangzhou 510150, People's Republic of China
| | - Chenchen Ren
- Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, People's Republic of China
| | - Qiming Wang
- Department of Obstetrics and Gynecology, Women and Children's Hospital of Ningbo City, Ningbo 315012, People's Republic of China
| | - Linqing Yang
- Department of Gynecology, Affiliated Hospital of Jining Medical University, Jining 272029, People's Republic of China
| | - Shuping Zhao
- Department of Gynecology, Women and Children's Hospital of Qingdao, Qingdao 266000, People's Republic of China
| | - Tianmin Xu
- Department of Obstetrics and Gynecology, The Second Hospital of Jilin University, Changchun 130000, People's Republic of China
| | - Xiaoxin Ma
- Department of Obstetrics and Gynecology, Shengjing Hospital Affiliated of China Medical University, Shenyang 110004, People's Republic of China
| | - Ruixia Guo
- Department of Gynecology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, People's Republic of China
| | - Pengming Sun
- Department of Obstetrics and Gynecology, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou 350001, People's Republic of China
| | - Yang Lin
- Department of Obstetrics and Gynecology, The Second Hospital of Jilin University, Changchun 130000, People's Republic of China
| | - Yuhong Li
- Department of Gynecologic Oncology, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Municipal Key Clinical Specialty, Shanghai Key Laboratory of Embryo Original Disease, Shanghai, 200030, People's Republic of China
| | - Jiandong Wang
- Department of Gynecologic Oncology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, People's Republic of China
| | - Yudong Wang
- Department of Gynecologic Oncology, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Municipal Key Clinical Specialty, Shanghai Key Laboratory of Embryo Original Disease, Shanghai, 200030, People's Republic of China
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6
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Yilmaz E, Oguz F, Tuncay G, Melekoglu R, Beytur A, Inci Coskun E, Gunes A. Renal cell carcinoma diagnosed during pregnancy: a case report and literature review. J Int Med Res 2018; 46:3422-3426. [PMID: 29882451 PMCID: PMC6134677 DOI: 10.1177/0300060518776744] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Diagnosing cancer during pregnancy is uncommon. Although pregnancies with concomitant malignancies have been reported, urological tumours are possibly the most rarely identified tumours during pregnancy. Renal cell carcinoma appears to be the most common urological malignancy during pregnancy. In this case report, we discuss successful management of a patient who was diagnosed with renal cell carcinoma during the antenatal period.
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Affiliation(s)
- Ercan Yilmaz
- 1 Department of Obstetrics and Gynecology, Faculty of Medicine, Inonu University, Malatya, Turkey
| | - Fatih Oguz
- 2 Department of Urology, Faculty of Medicine, Inonu University, Malatya, Turkey
| | - Gorkem Tuncay
- 1 Department of Obstetrics and Gynecology, Faculty of Medicine, Inonu University, Malatya, Turkey
| | - Rauf Melekoglu
- 1 Department of Obstetrics and Gynecology, Faculty of Medicine, Inonu University, Malatya, Turkey
| | - Ali Beytur
- 2 Department of Urology, Faculty of Medicine, Inonu University, Malatya, Turkey
| | - Ebru Inci Coskun
- 1 Department of Obstetrics and Gynecology, Faculty of Medicine, Inonu University, Malatya, Turkey
| | - Ali Gunes
- 2 Department of Urology, Faculty of Medicine, Inonu University, Malatya, Turkey
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7
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Boussios S, Moschetta M, Tatsi K, Tsiouris AK, Pavlidis N. A review on pregnancy complicated by ovarian epithelial and non-epithelial malignant tumors: Diagnostic and therapeutic perspectives. J Adv Res 2018; 12:1-9. [PMID: 29988841 PMCID: PMC6032492 DOI: 10.1016/j.jare.2018.02.006] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Revised: 02/15/2018] [Accepted: 02/27/2018] [Indexed: 12/21/2022] Open
Abstract
The management of gestational ovarian cancer can be challenging because of the risk of fetal wastage, and the possibility of treatment-related complications to the fetus; it is based on insufficient data from retrospective studies and case series. Here, a literature review of the diagnostic and surgical approaches to the gestational ovarian cancer has been performed; moreover, data on safety of chemotherapeutic treatments in pregnancy, including both oncologic and fetal outcomes, have also been reviewed. Up to now, 193 cases of ovarian cancers during pregnancy have been reported in the English literature. Treatment of ovarian malignancies during pregnancy depends on histology, stage, and gestational weeks. When possible, surgical excision is indicated, and fertility-sparing surgery can be offered to stage I epithelial ovarian tumours (EOC), germ cell ovarian, or sex-cord stromal ovarian tumours. Neoadjuvant and/or adjuvant chemotherapy for advanced ovarian tumours is indicated as in non-pregnant women. Administration of chemotherapy after the first trimester, can cause fetal growth restriction, while being seemingly safe. The therapeutic approach of ovarian cancer in pregnancy should be individualized and intended in specialized centers.
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Affiliation(s)
- Stergios Boussios
- Medical School, University of Ioannina, Stavros Niarchou Avenue, 45110 Ioannina, Greece
- Corresponding author.
| | - Michele Moschetta
- Drug Development Unit, Sarah Cannon Research Institute, 93 Harley Street, London W1G 6AD, UK
| | - Konstantina Tatsi
- Gynaecology Unit, General Hospital “G. Hatzikosta”, Makrigianni Avenue, 45001 Ioannina, Greece
| | - Alexandros K. Tsiouris
- Department of Biological Applications & Technology, University of Ioannina, Stavros Niarchou Avenue, 45110 Ioannina, Greece
| | - Nicholas Pavlidis
- Medical School, University of Cyprus, Old road Lefkosias Lemesou, No. 215/6, 2029 Aglantzia, Nicosia, Cyprus
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8
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Colorectal cancer during pregnancy. GINECOLOGIA.RO 2018. [DOI: 10.26416/gine.22.4.2018.2144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
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9
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Scavuzzo A, Santana Rios Z, Diaz-Gomez C, Varguez Gonzalez B, Osornio-Sanchez V, Bravo-Castro E, Linden-Castro E, Martinez-Cervera P, Jimenez-Rios MA. Renal Cell Carcinoma in a Pregnant Woman With Horseshoe Kidney. Urol Case Rep 2017; 13:58-60. [PMID: 28507908 PMCID: PMC5429143 DOI: 10.1016/j.eucr.2015.11.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2015] [Accepted: 11/04/2015] [Indexed: 11/29/2022] Open
Abstract
To our knowledge, this is the first reported case of renal cell carcinoma in kidney horseshoe diagnosed in the second trimester of pregnancy. We performed open radical nephrectomy when the pregnancy was completed. Kidney cancer is rare during pregnancy and the symptoms can be mimic urinary infection. The diagnosis and its management can be a challenge.
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Affiliation(s)
- Anna Scavuzzo
- Department of Urology, Instituto Nacional de Cancerologia, Mexico City 14080, Mexico
| | - Zael Santana Rios
- Department of Urology, Instituto Nacional de Cancerologia, Mexico City 14080, Mexico
| | - Cristobal Diaz-Gomez
- Department of Urology, Instituto Nacional de Cancerologia, Mexico City 14080, Mexico
| | | | | | - Edgar Bravo-Castro
- Department of Urology, Instituto Nacional de Cancerologia, Mexico City 14080, Mexico
| | - Edgar Linden-Castro
- Department of Urology, Instituto Nacional de Cancerologia, Mexico City 14080, Mexico
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10
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Rogers JE, Dasari A, Eng C. The Treatment of Colorectal Cancer During Pregnancy: Cytotoxic Chemotherapy and Targeted Therapy Challenges. Oncologist 2016; 21:563-70. [PMID: 27000464 DOI: 10.1634/theoncologist.2015-0362] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Accepted: 01/15/2016] [Indexed: 12/26/2022] Open
Abstract
UNLABELLED : Cancer diagnosed during pregnancy has increased because of delayed child-bearing and the known occurrence of age-dependent malignancies. Cases of colorectal cancer (CRC) in pregnancy have recently been reported. With the expected rise in CRC diagnosed in young adults coupled with the current trend of delayed child-bearing, CRC during pregnancy is likely to increase. Treating pregnant women with CRC by using antineoplastics presents a dilemma because there are many unknowns to guide treatment decisions. We review the issues regarding the use of 10 CRC-approved agents in pregnancy. IMPLICATIONS FOR PRACTICE Colorectal cancer (CRC) in pregnancy is likely to become more common because of the current population trend in delayed child-bearing and the increase in CRC incidence expected among young adults. Practitioners should become familiar with the challenges associated with systemic treatment of a pregnant patient with CRC. This review addresses concerns surrounding the 10 systemic agents approved for CRC to help provide treatment guidance when such a case arises.
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Affiliation(s)
- Jane E Rogers
- Pharmacy Clinical Programs, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Arvind Dasari
- Department of Gastrointestinal Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Cathy Eng
- Department of Gastrointestinal Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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11
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Basta P, Bak A, Roszkowski K. Cancer treatment in pregnant women. Contemp Oncol (Pozn) 2014; 19:354-60. [PMID: 26793018 PMCID: PMC4709394 DOI: 10.5114/wo.2014.46236] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2014] [Accepted: 08/08/2014] [Indexed: 12/17/2022] Open
Abstract
In general, strategies for the treatment of cancer in pregnancy should not differ significantly from the treatment regimens in non-pregnant women. However, this is difficult due to either the effects of anticancer drugs on the developing foetus or the possibility of long-term complications after the exposure to drugs and radiation. The decision about the introduction and continuation of treatment in the event of pregnancy should be preceded by a detailed analysis of the potential benefits and risks. There are no data to suggest that pregnancy termination alters the biological behaviour of the tumour or patient prognosis in the presence of appropriate antineoplastic therapy. All patients should be given appropriate advice and informed that there are insufficient scientific data to determine any generally accepted consensus. It is very important to always respect the will of the patient, and the moral judgment of the physician should have no impact on the decisions taken by the woman. If the woman decides to undergo active treatment and maintain her pregnancy, it is necessary to carry out consultations with experts in the field appropriate to the type of cancer. This paper presents a basic review of the literature on the targeted therapies currently used in selected cancers diagnosed during pregnancy: breast cancer, cervical cancer, Hodgkin's disease, melanoma, thyroid cancer, ovarian cancer, and colorectal cancer.
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Affiliation(s)
- Pawel Basta
- I Department of Surgery, Jagiellonian University, Medical College, Krakow, Poland
- Department of Gynaecology and Oncology, Lukaszczyk Oncology Centre, Bydgoszcz, Poland
| | - Anna Bak
- Department of Radiotherapy, Lukaszczyk Oncology Centre, Bydgoszcz, Poland
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12
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Liu Y, Liu Y, Wang Y, Chen X, Chen H, Zhang J. Malignancies associated with pregnancy: an analysis of 21 clinical cases. Ir J Med Sci 2014; 184:175-81. [PMID: 24563259 DOI: 10.1007/s11845-014-1083-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2013] [Accepted: 02/08/2014] [Indexed: 11/30/2022]
Abstract
AIM This study aimed at investigating the clinical characteristics of malignancies associated with pregnancy and to provide information for the development of suitable strategies of treating maternal malignancies. METHODS We conducted a retrospective analysis of 21 pregnant women with cancer who were admitted to our hospital between 2006 and 2012. The patients' clinical characteristics, treatment during pregnancy and postpartum, and pregnancy outcome were recorded. RESULTS There were 21 cases of malignancies associated with pregnancy, including 6 cases of cervical cancer, 6 cases of breast cancer, 3 cases of liver cancer, 2 cases of ovarian cancer, 2 cases of thyroid cancer, 1 case of nasopharyngeal carcinoma, and 1 case of malignant brain tumor. Of the 21 patients, 15 patients continued their pregnancies (9 of these patients received cancer treatment), whereas the other 6 terminated pregnancy. The modes of delivery included cesarean section (12 cases) and vaginal delivery (3 cases), which resulted in 17 newborns, 12 of them with preterm birth (12/17, 70.6 %). The gestational age was from 30 weeks + 5 days to 39 weeks. No neonatal malformations were found. CONCLUSIONS The management of malignancies associated with pregnancy is a challenge for doctors and patients. It should be based on histological subtype, disease stage, gestational age, obstetrics complications, and patient's preference regarding continuing the pregnancy.
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Affiliation(s)
- Y Liu
- Department of Obstetrics and Gynecology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510120, Guangdong, People's Republic of China
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13
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Le cancer bronchique de la femme enceinte : prise en charge diagnostique et thérapeutique en 2012. Rev Mal Respir 2013; 30:125-36. [DOI: 10.1016/j.rmr.2012.11.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2012] [Accepted: 10/18/2012] [Indexed: 12/31/2022]
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14
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GZIRI MINAMHALLEM, DEBIÈVE FRÉDÉRIC, DE CATTE LUC, MERTENS LUC, BARREA CATHERINE, VAN CALSTEREN KRISTEL, HAN SILENYN, HEYNS LIESBETH, AMANT FRÉDÉRIC. Chemotherapy during pregnancy: effect of anthracyclines on fetal and maternal cardiac function. Acta Obstet Gynecol Scand 2012; 91:1465-8. [DOI: 10.1111/j.1600-0412.2012.01524.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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