Paclitaxel and cisplatin chemotherapy for ovarian cancer during pregnancy: case report and review of the literature

Abstract

The safety of chemotherapy during pregnancy is debatable. We present a case of advanced ovarian cancer, diagnosed at week 28 of gestational age, treated with 2 cycles of paclitaxel/cisplatin (TC) chemotherapy during pregnancy, with no serious toxicity. At week 34, the patient underwent a caesarean section and delivered a healthy girl. Four additional cycles of TC were administered. Three months after completing chemotherapy, the patient developed abdominal progression and subsequently a huge metastatic cystic mass in the brain. Despite subsequent therapies, the patient died of progressive disease 35 months after the diagnosis. The infant had normal growth and development by 73 months of her age. This is another reported case of ovarian cancer diagnosed during the second trimester of the pregnancy treated with TC chemotherapy without apparent teratogenic effect.

Oridonin Suppresses Proliferation of Human Ovarian Cancer Cells via Blockage of mTOR Signaling

“…Each year in the United States, approximately 21,200 women are diagnosed with OvCa (2200<45 years of age), and 14,300 die from the disease (470<45 years of age) (Pollack et al, 2009). The standard therapy for advanced epithelial ovarian cancer (EOC) consists of cytoreductive surgery followed by chemotherapy, preferably including paclitaxel combined with cisplatin or carboplatin (Serkies et al, 2011). It is because of the rational use of operation and chemotherapy, that the estimated 5-year relative survival for women diagnosed with OvCa in 2006 was 44.0%, an increase from 36.1% for those diagnosed between 1975 to 1977 (Eheman et al, 2006).But drug toxicity and high price greatly limit the use of these drugs.…”

Taxanes for Ovarian Cancer during Pregnancy: A Systematic Review

“…Checking all the references of relevant reviews and eligible articles, 1 more study was included. Overall, 9 studies were eligible for the systematic review [6,7,8,9,10,11,12,13,14] (table 1). The aforementioned stages are illustrated in detail in figure 1.…”

“…In relation to paclitaxel, 8 articles (11 pregnancies, 12 newborns) were retrieved [6,7,8,9,10,11,12,14], while regarding docetaxel, 1 article (1 pregnancy, 1 newborn) was identified [13]. The mean age of ovarian cancer patients at diagnosis was 33 years (SD 5.1; median 33; range 24–42) [6,7,8,9,10,11,12,13,14].…”

“…The mean age of ovarian cancer patients at diagnosis was 33 years (SD 5.1; median 33; range 24–42) [6,7,8,9,10,11,12,13,14]. In 11 cases an ovarian cancer diagnosis was established [6,7,8,10,11,12,13,14], while in 1 case a dysgerminoma was finally diagnosed, being mistaken for ovarian carcinoma during pregnancy [9].…”

“…The GA at chemotherapy administration varied from 16 to 30 weeks [6,7,8,9,10,11,12,13,14]. In all cases chemotherapy was well tolerated during pregnancy; no grade 3 and 4 adverse events were reported [6,7,8,9,10,11,12,13,14]. Moreover, in all cases a caesarian section was performed; the mean GA at delivery was 35.7 weeks (SD 1.4; median 35.8; range 34–38) [6,7,8,9,10,11,12,13,14].…”