open access

Vol 4, No 2 (2008)
Review paper
Published online: 2008-05-13
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Emerging therapeutic options for breast cancer chemotherapy during pregnancy

Olivier Mir, Paul Berveiller, Stanislas Ropert, François Goffinet, Gérard Pons, Jean-Marc Treluyer, François Goldwasser
Onkol. Prak. Klin 2008;4(2):65-73.

open access

Vol 4, No 2 (2008)
REVIEW ARTICLES
Published online: 2008-05-13

Abstract

Breast cancer is the commonest solid tumor observed during pregnancy. Anthracycline-based chemotherapy is feasible during the 2nd and 3rd trimesters of pregnancy, but few data are available on recent and highly active drugs taxanes, vinorelbine and anti-HER-2 agents in this setting.
We carried out a comprehensive review of reports documenting the use of taxanes, vinorelbine, trastuzumab and lapatinib during pregnancy in the English literature, in order to evaluate their safety profile in pregnant patients.
Twenty-four pregnancies are described, in which no grade 3–4 maternal toxicity nor malformation in the offspring was reported. Whereas only one report studied the pharmacokinetics of paclitaxel (Taxol) during pregnancy, several preclinical reports indicate that the placental P-glycoprotein could prevent the transplacental transfer of taxanes and vinorelbine. The use of trastuzumab was associated with the occurrence of anhydramnios in three of six cases.
The administration of recent drugs taxanes and vinorelbine seems feasible during the 2nd and 3rd trimesters of pregnancy, with a favorable toxicity profile. In contrast, anti-HER-2 agents may obscure the normal development of the fetal kidney, and should be avoided during pregnancy.

Abstract

Breast cancer is the commonest solid tumor observed during pregnancy. Anthracycline-based chemotherapy is feasible during the 2nd and 3rd trimesters of pregnancy, but few data are available on recent and highly active drugs taxanes, vinorelbine and anti-HER-2 agents in this setting.
We carried out a comprehensive review of reports documenting the use of taxanes, vinorelbine, trastuzumab and lapatinib during pregnancy in the English literature, in order to evaluate their safety profile in pregnant patients.
Twenty-four pregnancies are described, in which no grade 3–4 maternal toxicity nor malformation in the offspring was reported. Whereas only one report studied the pharmacokinetics of paclitaxel (Taxol) during pregnancy, several preclinical reports indicate that the placental P-glycoprotein could prevent the transplacental transfer of taxanes and vinorelbine. The use of trastuzumab was associated with the occurrence of anhydramnios in three of six cases.
The administration of recent drugs taxanes and vinorelbine seems feasible during the 2nd and 3rd trimesters of pregnancy, with a favorable toxicity profile. In contrast, anti-HER-2 agents may obscure the normal development of the fetal kidney, and should be avoided during pregnancy.
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Keywords

breast cancer; docetaxel; paclitaxel; pregnancy; vinorelbine

About this article
Title

Emerging therapeutic options for breast cancer chemotherapy during pregnancy

Journal

Oncology in Clinical Practice

Issue

Vol 4, No 2 (2008)

Article type

Review paper

Pages

65-73

Published online

2008-05-13

Bibliographic record

Onkol. Prak. Klin 2008;4(2):65-73.

Keywords

breast cancer
docetaxel
paclitaxel
pregnancy
vinorelbine

Authors

Olivier Mir
Paul Berveiller
Stanislas Ropert
François Goffinet
Gérard Pons
Jean-Marc Treluyer
François Goldwasser

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