Association of Chemotherapy Timing in Pregnancy With Congenital Malformation

Abstract

IMPORTANCE Chemotherapy during the first trimester of pregnancy should be avoided owing to the risk of congenital malformations. However, the precise gestational age at which chemotherapy can be initiated safely remains unclear.OBJECTIVE To assess congenital malformation rates associated with gestational age at initiation of chemotherapy among pregnant women with cancer.

Pushing the boundaries. Concurrent Hodgkin lymphoma and breast cancer treatment with preservation of pregnancy: A case report

“…However, they preferred to preserve the pregnancy based on the available evidence of oncological treatment during pregnancy. Chemotherapy during the first 12 weeks of pregnancy is associated with an increased risk for congenital malformations in the fetus, whereas the incidence of congenital malformations in patients who received chemotherapy in the second or third trimester of pregnancy is comparable to the incidence of congenital malformations in the general population, approximately 3% ( van Gerwen et al, 2021 ). Children prenatally exposed to chemotherapy have normal cognitive and cardiac outcomes and a general development within normal ranges, provided that the chemotherapy was administered after 12 weeks of pregnancy ( Vandenbroucke et al, 2020 , Amant et al, 2015 , Vandenbroucke et al, 2017 ).…”

Highlights of the ‘I Congress ecancer Choosing Wisely’ March 30 and 31, 2022 Santa Cruz, Bolivia

“…Lastly, Dr Guadalupe made reference to the information from the congenital disease society where in her article she showed us how during the first trimester of pregnancy there is a greater risk of developing foetal problems and malformations compared to the second and third trimesters where these problems fall to approximately 4%–6% [ 11 ]. Finally, Dr Guadalupe mentioned that there is an increase worldwide in the incidence of breast cancer during pregnancy; she said that there are no changes in treatment standards, and when there are changes for the protection of the fetus, does not recommend the use of targeted antibodies.…”

“…Finally Ronald Limón MD (University Social Security, Bolivia), told us about two studies presented at SABCS 2021. The first study was the EMERALD study [ 11 ], a phase 3 trial on Elacestrant, an oral selective oestrogen receptor degrader (SERD) versus the investigator’s choice of endocrine monotherapy for ER+/HER2− advanced/metastatic BC (mBC) after progression on endocrine and prior CDK4/6 inhibitor therapy. Elacestrant (RAD1901) is an oral SERD that blocks the ER in a dose-dependent manner and inhibits oestradiol-dependent induction of gene transcription and cell proliferation in ER+ BC cell lines.…”

Successful cervical cancer treatment during a monochorionic diamniotic twin pregnancy in a patient with history of preterm delivery

“…When chemotherapy is administered after 12 weeks of gestation, the incidence of congenital malformations is comparable between the general population whereas chemotherapy during the first 12 weeks of gestation is associated with an increased risk for congenital malformations 7. Over the last decades, the trend to use chemotherapy during pregnancy has increased 8.…”