Breast Cancer (Diagnosed) During Pregnancy: Adapting Recent Advances in Breast Cancer Care for Pregnant Patients

Loibl, Sibylle; Schmidt, André; Gentilini, Oreste; Kaufman, Bella; Kuhl, Christiane K.; Denkert, Carsten; Minckwitz, Gϋnter von; Parokonnaya, Anastasia; Stensheim, Hanne; Thomssen, Christoph; Calsteren, Kristel Van; Poortmans, Philip; Berveiller, Paul; Markert, Udo R.; Amant, Frédéric

doi:10.1007/978-3-319-48848-6_59

Cited by 63 publications

(173 citation statements)

References 63 publications

Supporting

Mentioning

151

Contrasting

Unclassified

Order By: Relevance

Section: Management Of Cancer During Pregnancymentioning

confidence: 99%

“…[165][166][167] There is insufficient evidence regarding the safety of gadolinium-based contrast agents in pregnant women. 167 Surgery is possible at any time during pregnancy depending on the anatomic location of the tumor, although it may be beneficial to delay surgery, when possible, until after fetus viability. 165,167 Selection of an appropriate treatment plan for pregnant women is dependent on individual tumor biology and tumor stage, similar to the management of cancer in non-pregnant women.…”

Section: Management Of Cancer During Pregnancymentioning

confidence: 99%

“…167 Surgery is possible at any time during pregnancy depending on the anatomic location of the tumor, although it may be beneficial to delay surgery, when possible, until after fetus viability. 165,167 Selection of an appropriate treatment plan for pregnant women is dependent on individual tumor biology and tumor stage, similar to the management of cancer in non-pregnant women. In addition to the disease characteristics in pregnant women, the gestational age of the fetus is a significant factor in the selection of treatment.…”

Section: Management Of Cancer During Pregnancymentioning

confidence: 99%

“…166 Chemotherapy should be avoided during the first trimester because of greater risk of teratogenic effects, which include major congenital malformations, impaired organ function, spontaneous abortions, and fetal death. 167,[170][171][172][173] Although the use of chemotherapy during the second and third trimesters has not been associated with significant teratogenic effects, it may be associated with low birth weight, preterm labor, and intrauterine growth restriction. 157,170,172,[174][175][176] However, a multicenter, prospective case-control study of children born to mothers with cancer (129 cases, 129 controls) showed no significant impact of chemotherapy treatment on cognitive, cardiac, and general development of the offspring.…”

Section: Management Of Cancer During Pregnancymentioning

confidence: 99%

See 3 more Smart Citations

Adolescent and Young Adult Oncology, Version 2.2018, NCCN Clinical Practice Guidelines in Oncology

Coccia¹,

Pappo²,

Beaupin³

et al. 2018

J Natl Compr Canc Netw

253

194

View full text Add to dashboard Cite

Section: Management Of Cancer During Pregnancymentioning

confidence: 99%

Section: Management Of Cancer During Pregnancymentioning

confidence: 99%

Section: Management Of Cancer During Pregnancymentioning

confidence: 99%

Section: Management Of Cancer During Pregnancymentioning

confidence: 99%

See 2 more Smart Citations

Adolescent and Young Adult Oncology, Version 2.2018, NCCN Clinical Practice Guidelines in Oncology

Coccia¹,

Pappo²,

Beaupin³

et al. 2018

J Natl Compr Canc Netw

253

194

View full text Add to dashboard Cite

“…Breast cancer during pregnancy: management of patients with breast cancer during pregnancy is outside of scope of these guidelines and should follow established recommendations 143 . In general pregnant women can and should be treated as closely as possible to the general guidelines for BCYW.…”

Section: Brca Mutation Carriers (Table 8)mentioning

confidence: 99%

Second international consensus guidelines for breast cancer in young women (BCY2)

et al. 2016

Self Cite

View full text Add to dashboard Cite

Treatments During Pregnancy Targeting ERBB2 and Outcomes of Pregnant Individuals and Newborns

Gougis,

Grandal,

Jochum

et al. 2023

JAMA Netw Open

View full text Add to dashboard Cite

ImportanceTargeted therapies directed against ERBB2 are the cornerstone of medical treatment for ERBB2-positive breast cancers but are contraindicated during pregnancy.ObjectivesTo describe the association of exposure to anti-ERBB2 agents during pregnancy with pregnancy and fetal or newborn outcomes, and to compare the risk and types of adverse outcomes reported more frequently in this context than after exposure to other anticancer agents.Design, Setting, and ParticipantsFor this case-control study, All reports with a pregnancy-related condition and an antineoplastic agent (Anatomical Therapeutic Chemical classification group L01) registered in the World Health Organization international pharmacovigilance database VigiBase up to June 26, 2022, were extracted. All reports with a pregnancy, an antineoplastic treatment during pregnancy, and a cancer were retained. Reports with anticancer agents prescribed for nononcologic purposes were not included.ExposureThe exposure group was defined as reports that mention anti-ERBB2 agents compared with exposure to other anticancer agents.Main Outcome and MeasuresThe main outcome was the reporting odds ratio (ROR) for maternofetal complications in the group exposed to anti-ERBB2 agents compared with other anticancer agents, as determined using a disproportionality analysis.ResultsA total of 3558 reports (anti-ERBB2 agents, 328; other anticancer agents, 3230) were included in the analysis. In the group exposed to anti-ERBB2 agents, most reports were from the US (159 [48.5%]), the mean (SD) age of participants was 30.8 (10.4) years, and 209 patients (97.7%) were treated for breast cancers. The molecules most frequently involved in cases with anti-ERBB2 agents were trastuzumab (n = 302), pertuzumab (n = 55), trastuzumab-emtansine (n = 20), and lapatinib (n = 18). The outcomes overreported in these cases included oligohydramnios (ROR, 17.68 [95% CI, 12.26-25.52]; P &lt; .001), congenital respiratory tract disorders (ROR, 9.98 [95% CI, 2.88-34.67]; P &lt; .001), and neonatal kidney failure (ROR, 9.15 [95% CI, 4.62-18.12]; P &lt; .001). Sensitivity and multivariable analyses found similar results. Toxic effects were also significantly overreported for trastuzumab-emtansine (cardiovascular malformation: ROR, 4.46 [95% CI, 1.02-19.52]) and lapatinib (intrauterine growth restriction: ROR, 7.68 [95% CI, 3.01-19.59]).Conclusions and RelevanceIn this case-control study of 328 individuals exposed to anti-ERBB2 agents during pregnancy, exposure was associated with a severe specific adverse pregnancy and fetal or newborn outcomes compared with exposure to other anticancer treatments.

show abstract

Breast Cancer (Diagnosed) During Pregnancy: Adapting Recent Advances in Breast Cancer Care for Pregnant Patients

Cited by 63 publications

References 63 publications

Adolescent and Young Adult Oncology, Version 2.2018, NCCN Clinical Practice Guidelines in Oncology

Adolescent and Young Adult Oncology, Version 2.2018, NCCN Clinical Practice Guidelines in Oncology

Second international consensus guidelines for breast cancer in young women (BCY2)

Treatments During Pregnancy Targeting ERBB2 and Outcomes of Pregnant Individuals and Newborns

Contact Info

Product

Resources

About