Chemotherapy during pregnancy

Czech version

Authors: Michael Jiří Halaška ¹; K. Šuchová ¹; I. Špálová ¹; H. Robová ¹; H. Stankušová ²; M. Pluta ¹; Lukáš Rob ¹
Authors‘ workplace: Gynekologicko-porodnická klinika 2. LF UK a FN, Praha, přednosta prof. MUDr. L. Rob, CSc. ¹; Radioterapeuticko-onkologické oddělení FN Motol, Praha, primářka MUDr. J. Prausová, CSc. ²
Published in: Ceska Gynekol 2009; 74(4): 252-256
Category: Original Article

Overview

Objective:
The aim of the study is to summarize current data on chemotherapy administered during pregnancy.

Type of study:
Review article.

Setting:
Dept. of Obstetrics and Gynaecology of the Charles University in Prague, 2nd Medical Faculty, University Hospital.

Subject and method:
Pubmed database was searched between the years 1980 and 2009 with the combinations of key words concerning cytostatics, therapy and pregnancy. Cisplatin administration was identified in 38 cases. Eight cases of administration of carboplatin during pregnancy were found with normal neonatal outcome Twenty-one case reports were found on the use of taxanes during pregnancy: 14 on paclitaxel and 7 on docetaxel.

Conclusion:
Based on the literature the administration of cytostatics during pregnancy can be considered under a close supervision and long term follow-up in dedicated teams.

Key words:
chemotherapy, pregnancy, therapy, paclitaxel, cisplatine, anthracycline.

Sources

1. Zdravotnická ročenka ÚZIS - 2003. Praha: ÚZIS, 2003.

2. Andreadis, C., Charalampidou, M., Diamantopoulos, N., et al. Combined chemotherapy and radiotherapy during conception and first two trimesters of gestation in a woman with metastatic breast cancer. Gynecol Oncol, 2004, 95, p. 252-255.

3. Aviles, A., az-Maqueo, JC., Garcia, EL., et al. Late lethal events in patients with diffuse large B cell lymphoma: a review of 714 patients treated in a single centre. Leuk Lymphoma, 2001, 42, p. 631-637.

4. Bader, AA., Schlembach, D., Tamussino, KF., et al. Anhydramnios associated with administration of trastuzumab and paclitaxel for metastatic breast cancer during pregnancy. Lancet Oncol, 2007, 8, p. 79-81.

5. Bakri, YN., Given, FT. Jr. Normal pregnancy and delivery following conservative surgery and chemotherapy for ovarian endodermal sinus tumor. Gynecol Oncol 1984, 19, p. 222-225.

6. Berry, DL., Theriault, RL., Holmes, FA., et al. Management of breast cancer during pregnancy using a standardized protocol. J Clin Oncol, 1999, 17, p. 855-861.

7. Bodner-Adler, B., Bodner, K., Zeisler, H. Breast cancer diagnosed during pregnancy. Anticancer Res, 2007, 27, p. 1705-1707.

8. Caluwaerts, S., Van, CK., Mertens, L., et al. Neoadjuvant chemotherapy followed by radical hysterectomy for invasive cervical cancer diagnosed during pregnancy: report of a case and review of the literature. Int J Gynecol Cancer, 2006, 16, p. 905-908.

9. Cardonick, E., Iacobucci, A. Use of chemotherapy during human pregnancy. Lancet Oncol, 2004, 5, p. 283-291.

10. Caubel, P., Giovangrandi, Y., Lasry, S., et al. Ovarian seminoma and pregnancy. Apropos of a new case. J Gynecol Obstet Biol Reprod (Paris), 1989, 18, p. 487-491.

11. Christman, JE., Teng, NN., Lebovic, GS., Sikic, BI. Delivery of a normal infant following cisplatin, vinblastine, and bleomycin (PVB) chemotherapy for malignant teratoma of the ovary during pregnancy. Gynecol Oncol, 1990, 37, p. 292-295.

12. Cuvier, C., Espie, M., Extra, JM., Marty, M. Vinorelbine in pregnancy. Eur J Cancer, 1997, 33, p. 168-169.

13. De, SM., Lucchese, A., De, CS., et al. Metastatic breast cancer in pregnancy: first case of chemotherapy with docetaxel. Eur J Cancer Care, 2000, 9, p. 235-237.

14. Eedarapalli, P., Biswas, N., Coleman, M. Epirubicin for breast cancer during pregnancy: a case report. J Reprod Med, 2007, 52, p. 730-732.

15. Elit, L., Bocking, A., Kenyon, C., Natale, R. An endodermal sinus tumor diagnosed in pregnancy: case report and review of the literature. Gynecol Oncol, 1999, 72, p. 123-127.

16. Fanale, MA., Uyei, AR., Theriault, RL., et al. Treatment of metastatic breast cancer with trastuzumab and vinorelbine during pregnancy. Clin Breast Cancer, 2005, 6, p. 354-356.

17. Ferrandina, G., Distefano, M., Testa, A., et al. Management of an advanced ovarian cancer at 15 weeks of gestation: case report and literature review. Gynecol Oncol, 2005, 97, p. 693-696.

18. Gadducci, A., Cosio, S., Fanucchi, A., et al. Chemotherapy with epirubicin and paclitaxel for breast cancer during pregnancy: case report and review of the literature. Anticancer Res, 2003, 23, p. 5225-5229.

19. Gaillard, B., Leng, JJ., Grellet, J., et al. Transplacental passage of epirubicin. J Gynecol Obstet Biol Reprod, 1995, 24, p. 63-68.

20. Gainford, MC., Clemons, M. Breast cancer in pregnancy: are taxanes safe? Clin Oncol (R Coll Radiol), 2006, 18, p. 159.

21. Garcia-Gonzalez, J., Cueva, J., Lamas, MJ., et al. Paclitaxel and cisplatin in the treatment of metastatic non-small-cell lung cancer during pregnancy. Clin Transl Oncol, 2008, 10, p. 375-376.

22. Garcia-Manero, M., Royo, MP., Espinos, J., et al. Pregnancy associated breast cancer. Eur J Surg Oncol, 2008, 10, 6.

23. Garrido, M., Clavero, J., Huete, A., et al. Prolonged survival of a woman with lung cancer diagnosed and treated with chemotherapy during pregnancy. Lung Cancer, 2008, 60, p. 285-290.

24. Giacalone, PL., Laffargue, F., Benos, P. Chemotherapy for breast carcinoma during pregnancy: A French national survey. Cancer, 1999, 86, p. 2266-2271.

25. Ginopoulos, PV., Michail, GD., Kourounis, GS. Pregnancy associated breast cancer: a case report. Eur J Gynaecol Oncol, 2004, 25, p. 261-263.

26. Goldwasser, F., Pico, JL., Cerrina, J., et al. Successful chemotherapy including epirubicin in a pregnant non-Hodgkin’s lymphoma patient. Leuk Lymphoma, 1995, 20, p. 173-176.

27. Gonzalez-Angulo, A., Walters, R., Carpenter, RJ., et al. Paclitaxel chemotherapy in a pregnancy patient with bilateral breast cancer. Clin Breast Cancer, 2004, 5, p. 317-319.

28. Hahn, KM., Johnson, PH., Gordon, N., et al. Treatment of pregnant breast cancer patients and outcomes of children exposed to chemotherapy in utero. Cancer, 2006, 107, p. 1219-1226.

29. Halaska, MJ., Pentheroudakis, G., Strnad, P., et al. Presentation, management and outcome of 32 patients with pregnancy-associated breast cancer: A matched controlled study. Breast, 2009, in press.

30. Han, JY., Nava-Ocampo, AA., Kim, TJ., et al. Pregnancy outcome after prenatal exposure to bleomycin, etoposide and cisplatin for malignant ovarian germ cell tumors: report of 2 cases. Reprod Toxicol, 2005, 19, p. 557-561.

31. Henderson, CE., Elia, G., Garfinkel, D., et al. Platinum chemotherapy during pregnancy for serous cystadenocarcinoma of the ovary. Gynecol Oncol, 1993, 49, p. 92-94.

32. Horbelt, D., Delmore, J., Meisel, R., et al. Mixed germ cell malignancy of the ovary concurrent with pregnancy. Obstet Gynecol, 1994, 84, p. 662-664.

33. Hubalek, M., Smekal-Schindelwig, C., Zeimet, AG., et al. Chemotherapeutic treatment of a pregnant patient with ovarian dysgerminoma. Arch Gynecol Obstet, 2007, 276, p. 179-183.

34. Johnson, S. Cognitive and behavioural outcomes following very preterm birth. Semin Fetal Neonatal Med, 2007, 12, p. 363-373.

35. Karimi, ZM., Behtash, N., Modares, GM. Good pregnancy outcome after prenatal exposure to bleomycin, etoposide and cisplatin for ovarian immature teratoma: a case report and literature review. Arch Gynecol Obstet, 2008, 277, p. 75-78.

36. Kim, DS., Park, MI. Maternal and fetal survival following surgery and chemotherapy of endodermal sinus tumor of the ovary during pregnancy: a case report. Obstet Gynecol, 1989, 73, p. 503-507.

37. Kim, JH., Kim, HS., Sung, CW., et al. Docetaxel, gemcitabine, and cisplatin administered for non-small cell lung cancer during the first and second trimester of an unrecognized pregnancy. Lung Cancer, 2008, 59, p. 270-273.

38. Lipshultz, SE., Colan, SD., Gelber, RD., et al. Late cardiac effects of doxorubicin therapy for acute lymphoblastic leukemia in childhood. N Engl J Med, 1991, 324, p. 808-815.

39. Lycette, JL., Dul, CL., Munar, M., et al. Effect of pregnancy on the pharmacokinetics of paclitaxel: a case report. Clin Breast Cancer, 2006, 7, p. 342-344.

40. Machado, F., Vegas, C., Leon, J., et al. Ovarian cancer during pregnancy: analysis of 15 cases. Gynecol Oncol, 2007, 105, p. 446-450.

41. Malhotra, N., Sood, M. Endodermal sinus tumor in pregnancy. Gynecol Oncol, 2000, 78, p. 265-266.

42. Malone, JM., Gershenson, DM., Creasy, RK., et al. Endodermal sinus tumor of the ovary associated with pregnancy. Obstet Gynecol, 1986, 68, p. 86S-89S.

43. Mantovani, G., Gramignano, G., Mais, V., et al. Use of chemotherapy for ovarian cancer during human pregnancy: case report and literature review. Eur J Obstet Gynecol Reprod Biol. 2007, 131, p. 238-239.

44. Mathelin, C., Annane, K., Dufour, P., et al. Chemotherapy for breast cancer during pregnancy. Eur J Obstet Gynecol Reprod Biol, 2005, 123, p. 260-262.

45. Mendez, LE., Mueller, A., Salom, E., Gonzalez-Quintero, VH. Paclitaxel and carboplatin chemotherapy administered during pregnancy for advanced epithelial ovarian cancer. Obstet Gynecol, 2003, 102, p. 1200-1202.

46. Mendez, LE., Mueller, A., Salom, E., Gonzalez-Quintero, VH. Paclitaxel and carboplatin chemotherapy administered during pregnancy for advanced epithelial ovarian cancer. Obstet Gynecol, 2003, 102, p. 1200-1202.

47. Mir, O., Berveiller, P., Ropert, S., et al. Emerging therapeutic options for breast cancer chemotherapy during pregnancy. Ann Oncol, 2008, 19, p. 607-613.

48. Modares, GM., Karimi, ZM., Behtash, N., et al. Preservation of pregnancy in a patient with advanced ovarian cancer at 20 weeks of gestation: case report and literature review. Int J Gynecol Cancer, 2007, 17, p. 1140-1143.

49. Motegi, M., Takakura, S., Takano, H., et al. Adjuvant chemotherapy in a pregnant woman with endodermal sinus tumor of the ovary. Obstet Gynecol, 2007, 109, p. 537-540.

50. Muller, T., Hofmann, J., Steck, T. Eclampsia after polychemotherapy for nodal-positive breast cancer during pregnancy. Eur J Obstet Gynecol Reprod Biol, 1996, 67, p. 197-198.

51. Nieto, Y., Santisteban, M., Aramendia, JM., et al. Docetaxel administered during pregnancy for inflammatory breast carcinoma. Clin Breast Cancer, 2006, 6, p. 533-534.

52. Otton, G., Higgins, S., Phillips, KA., Quinn, M. A case of early-stage epithelial ovarian cancer in pregnancy. Int J Gynecol Cancer, 2001, 11, p. 413-417.

53. Palaia, I., Pernice, M., Graziano, M., et al. Neoadjuvant chemotherapy plus radical surgery in locally advanced cervical cancer during pregnancy: a case report. Am J Obstet Gynecol, 2007, 197, p. e5-e6.

54. Pant, S., Landon, MB., Blumenfeld, M., et al. Treatment of breast cancer with trastuzumab during pregnancy. J Clin Oncol, 2008, 26, p. 1567-1569.

55. Peccatori, F., Martinelli, G., Gentilini, O., Goldhirsch, A. Chemotherapy during pregnancy: what is really safe? Lancet Oncol, 2004, 5, p. 398.

56. Pentheroudakis, G., Pavlidis, N. Cancer and pregnancy: Poena magna, not anymore. Eur J Cancer, 2006, 42, p. 126-140.

57. Picone, O., Lhomme, C., Tournaire, M., et al. Preservation of pregnancy in a patient with a stage IIIB ovarian epithelial carcinoma diagnosed at 22 weeks of gestation and treated with initial chemotherapy: case report and literature review. Gynecol Oncol, 2004, 94, p. 600-604.

58. Potluri, V., Lewis, D., Burton, GV. Chemotherapy with taxanes in breast cancer during pregnancy: case report and review of the literature. Clin Breast Cancer, 2006, 7, p. 167-170.

59. Raffles, A., Williams, J., Costeloe, K., Clark, P. Transplacental effects of maternal cancer chemotherapy. Case report. Br J Obstet Gynaecol, 1989, 96, p. 1099-1100.

60. Ring, AE., Smith, IE., Jones, A., et al. Chemotherapy for breast cancer during pregnancy: An 18-year experience from Five London Teaching Hospital. J Clin Oncol, 2005, 23, p. 4192-4196.

61. Robova, H., Rob, L., Hrehorcak, M., et al. Endodermal sinus tumor diagnosed in pregnancy: a case report. Int J Gynecol Cancer, 2007, 17, p. 914-916.

62. Sekar, R., Stone, PR. Trastuzumab use for metastatic breast cancer in pregnancy. Obstet Gynecol, 2007, 110, p. 507-510.

63. Shrim, A., Garcia-Bournis, sen. F., Maxwell, C., et al. Favorable pregnancy outcome following Trastuzumab (HerceptinR) use during pregnancy - Case report and updated literature review. Reprod Toxicol, 2007, 24.

64. Sood, AK., Shahin, MS., Sorosky, JI. Paclitaxel and platinum chemotherapy for ovarian carcinoma during pregnancy. Gynecol Oncol, 2001, 83, p. 599-600.

65. Tabata, T., Nishiura, K., Tanida, K., et al. Carboplatin chemotherapy in a pregnant patient with undifferentiated ovarian carcinoma: case report and review of the literature. Int J Gynecol Cancer, 2008, 18, p. 181-184.

66. van Calsteren, K., Berteloot, P., Hanssens, M., et al. In utero exposure to chemotherapy: effect on cardiac and neurologic outcome. J Clin Oncol, 2006, 24, p. e16-e17.

67. Witzel, ID., Muller, V., Harps, E., et al. Trastuzumab in pregnancy associated with poor fetal outcome. Ann Oncol, 2008, 19, p. 191-19a.

68. Zemlickis, D., Lishner, M., Erlich, R., Koren, G. Teratogenicity and carcinogenicity in a twin exposed in utero to cyclophosphamide. Teratog Carcinog Mutagen, 1993, 13, p. 139-143.