Neoadjuvant chemotherapy with paclitaxel plus platinum for invasive cervical cancer in pregnancy: two case report and literature review

Abstract

Neoadjuvant chemotherapy with paclitaxel plus cisplatin appears to be feasible and safe for pregnant patients with invasive cervical cancer and infants.

Platinum Derivatives During Pregnancy in Cervical Cancer

“…17 The mean age of patients with cervical cancer at diagnosis was 32.5 years (standard deviation [SD] 4.3, median 32.5 years, range 25-42 years). In 78.6% of women in the case group (33/42), a diagnosis of squamous cell carcinoma was established, [11][12][13][14][15][16][17]19,[21][22][23][24][25][26][27]29,31,34 whereas in 14.3% of women in the case group (6/42), adenocarcinoma was diagnosed 11,14,15,18,19,34 ; additionally, one woman each in the case groups of clear cell, of small cell, and of glossy cell carcinoma was identified. 17,20,30 The stage at diagnosis during pregnancy was early (stages I and II) in 93.5% of women in the case group and advanced in 6.5% of women in the case group.…”

“…The administration of platinum derivatives resulted in 97.9% of women in the case group (47/48) in the birth of live neonates [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][32][33][34] and in 2.1% of women in the case group (1/48) in miscarriage. 31 In relation to cisplatin, 47 pregnancies (47 newborns) were identified ; regarding carboplatin administration, only one pregnancy (one newborn) was retrieved.…”

How much platinum passes the placental barrier? Analysis of platinum applications in 21 patients with cervical cancer during pregnancy

“…37 Empirically cisplatinum 50e100 mg/m 2 every 3 weeks or 20e50 mg/m 2 weekly is proposed as standard treatment during pregnancy because of its frequent use in pregnancy, although limited valid data of transplacentar passage of platinum is available. 38,39 The dosage used for nearly all patients in the present study is exactly in this range, whereas the number of applied cycles mainly depends on the time of the cancer diagnosis. 26,27,40 Because of a lack of data, it is not decided yet whether neoadjuvant monotherapy using cisplatinum or carboplatinum is inferior to any combination with paclitaxel, 5-fluorouracil, or vincristine.…”

Taxanes for Ovarian Cancer during Pregnancy: A Systematic Review

“…they can be administered in pregnancy if necessary). It is worth noting that taxanes have been administered during pregnancy in breast [1,14,16,17,18], cervical [19,20] and non-small cell lung cancer patients [21,22], with promising results. Moreover, according to ESMO guidelines [23], they are relatively safe to administer beyond the first gestational trimester.…”