Cancer Treatment and Immunotherapy during Pregnancy

Koutras, Antonios; Ntounis, Thomas; Fasoulakis, Zacharias; Papalios, Theodoros; Pittokopitou, Savia; Prokopakis, Ioannis; Syllaios, Athanasios; Valsamaki, Asimina; Chionis, Athanasios; Symeonidis, Panagiotis D.; Samara, Athina A.; Pagkalos, Athanasios; Pergialiotis, Vasilios; Theodora, Marianna; Antsaklis, Panos J.; Daskalakis, G.; Kontomanolis, Emmanuel N

doi:10.3390/pharmaceutics14102080

Cited by 4 publications

(3 citation statements)

References 81 publications

(120 reference statements)

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“…Of note, atrial septal defect, intrauterine growth restriction, preterm delivery, pre-eclampsia, and death have been reported for the pregnant patients being exposed to either vincristine or vinblastine [ 78 ]. Furthermore, six pregnant patients with brain gliomas who received either temozolomide or the combination of procarbazine, lomustine, and vincristine in the first month of the pregnancy unintentionally delivered healthy babies [ 79 ]. Temozolomide is a category D pregnancy medication which is not generally recommended, but it can be used if the benefits to the mother outweigh the risks to the fetus.…”

Section: Discussionmentioning

confidence: 99%

Awake craniotomy during pregnancy: A systematic review of the published literature

Mofatteh,

Mashayekhi,

Arfaie

et al. 2023

Neurosurg Rev

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Neurosurgical pathologies in pregnancy pose significant complications for the patient and fetus, and physiological stressors during anesthesia and surgery may lead to maternal and fetal complications. Awake craniotomy (AC) can preserve neurological functions while reducing exposure to anesthetic medications. We reviewed the literature investigating AC during pregnancy. PubMed, Scopus, and Web of Science databases were searched from the inception to February 7th, 2023, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. Studies in English investigating AC in pregnant patients were included in the final analysis. Nine studies composed of nine pregnant patients and ten fetuses (one twin-gestating patient) were included. Glioma was the most common pathology reported in six (66.7%) patients. The frontal lobe was the most involved region (4 cases, 44.4%), followed by the frontoparietal region (2 cases, 22.2%). The awake-awake-awake approach was the most common protocol in seven (77.8%) studies. The shortest operation time was two hours, whereas the longest one was eight hours and 29 min. The mean gestational age at diagnosis was 13.6 ± 6.5 (2—22) and 19.6 ± 6.9 (9—30) weeks at craniotomy. Seven (77.8%) studies employed intraoperative fetal heart rate monitoring. None of the AC procedures was converted to general anesthesia. Ten healthy babies were delivered from patients who underwent AC. In experienced hands, AC for resection of cranial lesions of eloquent areas in pregnant patients is safe and feasible and does not alter the pregnancy outcome.

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Section: Discussionmentioning

confidence: 99%

Awake craniotomy during pregnancy: A systematic review of the published literature

Mofatteh,

Mashayekhi,

Arfaie

et al. 2023

Neurosurg Rev

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“…During pregnancy, the maternal immune system faces the task of tolerating the fetus while also protecting against infections and toxins. This process happens in three phases: first, a pro-inflammatory state supports implantation and placenta formation; second, an anti-inflammatory environment develops in the uterus during the second and third trimesters; finally, a second pro-inflammatory stage triggers uterine contractions, fetal delivery, and placental expulsion during parturition [41]. In the realm of immunotherapy, immune checkpoint inhibitors (ICIs) stand out as the prevailing class of therapeutic agents.…”

Section: Immunotherapy and Targeted Agentsmentioning

confidence: 99%

Cancer and Pregnancy in the Post-Roe v. Wade Era: A Comprehensive Review

Arup,

Shravan

2023

Current Oncology

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Cancer during pregnancy, affecting 1 in 1000 pregnancies, is rising in incidence due to delayed childbearing and improved detection. Common types include breast cancer, melanoma and cervical cancer and Hodgkin’s Lymphoma. There are several physiological changes that occur during pregnancy that make its management a challenge to clinicians. Managing it requires multidisciplinary approaches and cautious test interpretation due to overlapping symptoms. To minimize fetal radiation exposure, non-ionizing imaging is preferred, and the interpretation of tumor markers is challenging due to inflammation and pregnancy effects. In terms of treatment, chemotherapy is avoided in the first trimester but may be considered later. Immunotherapy’s safety is under investigation, and surgery depends on gestational age and cancer type. Ethical and legal concerns are growing, especially with changes in U.S. abortion laws. Access to abortion for medical reasons is vital for pregnant cancer patients needing urgent treatment. Maternal outcomes may depend on the type of cancer as well as chemotherapy received but, in general, they are similar to the non-pregnant population. Fetal outcomes are usually the same as the general population with treatment exposure from the second trimester onwards. Fertility preservation may be an important component of the treatment discussion depending on the patient’s wishes, age and type of treatment. This article addresses the complicated nature of a diagnosis of cancer in pregnancy, touching upon the known medical literature as well as the ethical–legal implications of such a diagnosis, whose importance has increased in the light of recent judicial developments.

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“…Cancer is the second leading cause of death around the world, and while dysfunctional DNA can contribute to its development, it is not the sole cause. Other factors such as genetics, environmental exposures, altered cellular pathways, proteins and transcription factors, have been associated with the progression, differentiation and development of different kinds of cancer [ 4 ]. It is believed that certain medicines can kill cancer cells or cause them to shrink [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of anticancer potential of tetracene-5,12-dione (A01) and pyrimidine-2,4-dione (A02) via caspase 3 and lactate dehydrogenase cytotoxicity investigations

Aziz,

Sarfraz,

Khurrum Ibrahim

et al. 2023

PLoS ONE

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Cancer stands as a significant global cause of mortality, predominantly arising from the dysregulation of key enzymes and DNA. One strategic avenue in developing new anticancer agents involves targeting specific proteins within the cancer pathway. Amidst ongoing efforts to enhance the efficacy of anticancer drugs, a range of crucial medications currently interact with DNA at the molecular level, exerting profound biological effects. Our study is driven by the objective to comprehensively explore the potential of two compounds: (7S,9S)-7-[(2R,4S,5S,6S)-4-amino-5-hydroxy-6-methyloxan-2-yl]oxy-6,9,11-trihydroxy-9-(2-hydroxyacetyl)-4-methoxy-8,10-dihydro-7H-tetracene-5,12-dione (A01) and 5-fluoro-1H-pyrimidine-2,4-dione (A02). These compounds have demonstrated marked efficacy against breast and cervical cancer cell lines, positioning them as promising anticancer candidates. In our investigation, A01 has emerged as a particularly potent candidate, with its potential bolstered by corroborative evidence from lactate dehydrogenase release and caspase-3 activity assays. On the other hand, A02 has exhibited remarkable anticancer potential. To further elucidate their molecular mechanisms and interactions, we employed computational techniques, including molecular docking and molecular dynamics simulations. Notably, our computational analyses suggest that the A01-DNA complex predominantly interacts via the minor groove, imparting significant insights into its mechanism of action. While earlier studies have also highlighted the anticancer activity of A01, our research contributes by providing a deeper understanding of its binding mechanisms through computational investigations. This knowledge holds potential for designing more effective drugs that target cancer-associated proteins. These findings lay a robust groundwork for future inquiries and propose that derivatives of A01 could be synthesized as potent bioactive agents for cancer treatment. By elucidating the distinctive aspects of our study’s outcomes, we address the concern of distinguishing our findings from those of prior research.

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Cancer Treatment and Immunotherapy during Pregnancy

Cited by 4 publications

References 81 publications

Awake craniotomy during pregnancy: A systematic review of the published literature

Awake craniotomy during pregnancy: A systematic review of the published literature

Cancer and Pregnancy in the Post-Roe v. Wade Era: A Comprehensive Review

Evaluation of anticancer potential of tetracene-5,12-dione (A01) and pyrimidine-2,4-dione (A02) via caspase 3 and lactate dehydrogenase cytotoxicity investigations

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