The fetal outcomes after neoadjuvant platinum and paclitaxel chemotherapy during pregnancy: analysis of three cases and review of the literature

Wang, Ming; Yin, Ziran; Miao, Jinwei; Wu, Yumei

doi:10.1007/s00404-021-06113-8

Cited by 6 publications

(4 citation statements)

References 26 publications

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“…Experience with the use of taxanes in pregnancy is much more limited than with platinum derivatives. All the data available to date, obtained from retrospective studies and case reports, confirm the feasibility and safety of using taxanes during the second and third trimesters of pregnancy [ 24 , 25 , 26 ].…”

Section: Discussionmentioning

confidence: 95%

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Neoadjuvant Chemotherapy in Pregnant Patients with Cervical Cancer: A Monocentric Retrospective Study

et al. 2022

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Background: To date, little and discordant data still exists on the management of cervical cancer (CC) during pregnancy. In this paper, we report our experience of the treatment of these patients analyzing the oncologic, obstetric, and neonatal outcomes. Methods: Between January 2010 and December 2021, 13 patients were diagnosed with CC during pregnancy. All patients underwent platinum-based neoadjuvant chemotherapy (NACT) and 11/13 patients underwent a cesarean radical hysterectomy (CRH). Results: All 13 patients were diagnosed with squamous-cell carcinoma, FIGO-2018 stage between IB2-IIIC1. The majority of patients had a partial (61.5%) or complete (15.4%) response to NACT. Most patients had a regular course of pregnancy and the obstetric complications observed were gestational diabetes mellitus in 23.1% and IUGR in 15.4% of cases. CRH was performed in the absence of major complications. Only 2 patients (15.4%) had disease recurrence and only 1 patient (7.7%) died of disease. All children are currently healthy. At birth, we observed mainly prematurity-related complications (38.5% respiratory distress syndrome and 7.7% neonatal jaundice) and only a case of congenital malformation (hypospadias). In our pediatric population, we reported a case of malignancy (acute myeloid leukemia). Conclusion: NACT seems to be safe and efficacious in controlling tumor burden during pregnancy. CRH following NACT appears to be feasible, avoiding repeated surgery and treatment delays. This approach is also reasonably safe from a maternal, obstetric, and neonatal point of view.

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Section: Discussionmentioning

confidence: 95%

“…At birth, approximately 19% of newborns have adverse events [ 25 ], often related to prematurity whose incidence ranges from 48 to 61% [ 6 , 29 ]. The most frequent are respiratory distress syndrome and pathological jaundice.…”

Section: Discussionmentioning

confidence: 99%

Neoadjuvant Chemotherapy in Pregnant Patients with Cervical Cancer: A Monocentric Retrospective Study

et al. 2022

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“…In a large (n=1170 women) cohort study of obstetric and neonatal outcomes in women diagnosed with cancer during pregnancy, 88% of the pregnancies resulted in a livebirth (15). A recent review reported livebirth in all 36 pregnant women treated with platinum-based chemotherapy (16). However, despite the relatively high survival of chemotherapy-exposed fetuses, there are no reports on the impacts of intrauterine cisplatin exposure on gonadal relate to variation in the proliferation rate, 20-30% in gonocytes compared with 0-5% in (pre)spermatogonia, between these two populations during the second trimester (17).…”

Section: Impacts Of In Utero Exposure To Cisplatin On Human Fetal Tes...mentioning

confidence: 99%

Cisplatin Effects on the Human Fetal Testis – Establishing the Sensitive Period for (Pre)Spermatogonial Loss and Relevance for Fertility Preservation in Pre-Pubertal Boys

Matilionyte

Rimmer²,

Spears³

et al. 2022

Front. Endocrinol.

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BackgroundExposure to chemotherapy during childhood can impair future fertility. Studies using in vitro culture have shown exposure to platinum-based alkylating-like chemotherapy reduces the germ cell number in the human fetal testicular tissues. We aimed to determine whether effects of exposure to cisplatin on the germ cell sub-populations are dependent on the gestational age of the fetus and what impact this might have on the utility of using human fetal testis cultures to model chemotherapy exposure in childhood testis.MethodsWe utilised an in vitro culture system to culture pieces of human fetal testicular tissues (total n=23 fetuses) from three different gestational age groups (14-16 (early), 17-19 (mid) and 20-22 (late) gestational weeks; GW) of the second trimester. Tissues were exposed to cisplatin or vehicle control for 24 hours, analysing the tissues 72 and 240 hours post-exposure. Number of germ cells and their sub-populations, including gonocytes and (pre)spermatogonia, were quantified.ResultsTotal germ cell number and number of both germ cell sub-populations were unchanged at 72 hours post-exposure to cisplatin in the testicular tissues from fetuses of the early (14-16 GW) and late (20-22 GW) second trimester. In the testicular tissues from fetuses of mid (17-19 GW) second trimester, total germ cell and gonocyte number were significantly reduced, whilst (pre)spermatogonial number was unchanged. At 240 hours post-exposure, the total number of germ cells and that of both sub-populations was significantly reduced in the testicular tissues from fetuses of mid- and late-second trimester, whilst germ cells in early-second trimester tissues were unchanged at this time-point.ConclusionsIn vitro culture of human fetal testicular tissues can be a useful model system to investigate the effects of chemotherapy-exposure on germ cell sub-populations during pre-puberty. Interpretation of the results of such studies in terms of relevance to later (infant and pre-pubertal) developmental stages should take into account the changes in germ cell composition and periods of germ cell sensitivity in the human fetal testis.

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“…NACT should be initiated after 14 GW, and it is no longer a viable option after 27 GW because it should be administered at least 3 weeks after the initial surgery, and the final course should be conducted 3 weeks or 4 weeks before the expected date of delivery to avoid maternal–fetal aplasia. [ 5 ] Accordingly, definitive surgical treatment is recommended until 34 GW.…”

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confidence: 99%

Malignant ovarian tumors during pregnancy: Diagnostic evaluation, optimal treatment, and future perspective

Sheng,

Yuan,

et al. 2024

Chinese Medical Journal

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The fetal outcomes after neoadjuvant platinum and paclitaxel chemotherapy during pregnancy: analysis of three cases and review of the literature

Cited by 6 publications

References 26 publications

Neoadjuvant Chemotherapy in Pregnant Patients with Cervical Cancer: A Monocentric Retrospective Study

Neoadjuvant Chemotherapy in Pregnant Patients with Cervical Cancer: A Monocentric Retrospective Study

Cisplatin Effects on the Human Fetal Testis – Establishing the Sensitive Period for (Pre)Spermatogonial Loss and Relevance for Fertility Preservation in Pre-Pubertal Boys

Malignant ovarian tumors during pregnancy: Diagnostic evaluation, optimal treatment, and future perspective

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