Paclitaxel and Carboplatin Treatment for Advanced Ovarian Cancer during Pregnancy

Abstract

Ovarian carcinoma during pregnancy is a rare event that should be treated. In these cases, due to the lack of information available, doubts about the safety of mother and fetus are present. In this report, a 42-year-old woman who was diagnosed with a stage III ovarian carcinoma received six cycles of chemotherapy with carboplatin and paclitaxel from the 16th until 36th week of gestation. At 38 weeks, a normal male baby was born. There were no abnormalities during birth and during a 2-month follow-up period. This case adds to the available literature and supports the use of these chemotherapy agents during pregnancy, if the risk-benefit balance is appropriate.

Ovarian dysgerminoma in pregnancy: A case report and literature review

“…It is reported that paclitaxel and carboplatin were used in pregnancy after organogenesis without apparent fetal effects, though the evidence was mainly based on case reports. 10,42,[49][50][51][52][53] In nonpregnant patients, the combination of bleomycin-etoposide-cisplatin (BEP) is used for nonepithelial ovarian tumors. The patient who was administered etoposide and cisplatin in our selected case carried her pregnancy to term without congenital defects.…”

Advanced ovarian cancer treated in pregnancy and detected by cell-free DNA aneuploidy screening

“…Therefore, data on the management of advanced stage epithelial ovarian cancer in pregnancy are largely derived from case reports ( Cordeiro & Gemignani, 2017 ). In currently reported cases (n = 5), visible disease at initial surgery was confined to the ovaries and omentum, platinum-based doublet chemotherapy was effective, and interval surgery was limited to Cesarean section and completion staging ( Cordeiro & Gemignani, 2017 ; Ramos et al, 2013 ; Modares Gilani et al, 2007 ). The present case is unique in that the patient presented with stage IVA disease with carcinomatosis, progressed during treatment with carboplatin monotherapy, and required extensive cytoreduction at time of Cesarean hysterectomy to achieve no gross residual.…”

Gynecologic Malignancies in Pregnancy: Balancing Fetal Risks With Oncologic Safety

“…Of note, the authors described successful radical debulking surgery at the time of Cesarean delivery in this case. Similarly, Ramos et al 46 report a case of stage III ovarian cancer diagnosed in the fifteenth week of gestation, in which right salpingo-oophorectomy, lymph node dissection, and appendectomy were followed by adjuvant carboplatin and paclitaxel. A normal infant was born by Cesarean section with no evidence of physical or neurological anomalies at 2 months.…”

“…and one congenital anomaly. 45 Ramos et al 46 also reported on the use of the combination of paclitaxel and carboplatin during 16–36 weeks of gestation, resulting in a full-term live birth without evidence of neonatal abnormalities at birth or at two months follow-up.…”