Treatment of Metastatic Colorectal Cancer in a Pregnant Woman with Lynch Syndrome- A Case Report

Sultan, Anita; Kaleem, Hassan; Radhi, Saba

doi:10.4172/2329-6771.1000175

Cited by 2 publications

(3 citation statements)

References 27 publications

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“…CRC in pregnancy is likely to become more common as women elect to delay pregnancy late into their 3rd and 4th decades of life [ 5 ]. Furthermore, the incidence of CRC is increasing in younger adults [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

“…Chemotherapy is often continued until a gestational age of 35 weeks or 3 weeks before the expected due date [ 7 ]. This is recommended so as to avoid the increased risk of chemotherapy-related complications, such as bone marrow suppression, hemorrhage, and maternal and fetal death during delivery [ 5 , 15 ]. In this case report, 1 patient began chemotherapy in the early second trimester, while the other started in the late second trimester.…”

Section: Discussionmentioning

confidence: 99%

“…There have been numerous case reports of pregnant women with metastatic CRC receiving combination chemotherapy with FOLFOX or FOLFIRI [ 3 , 5 ]. However, to our knowledge, there have been no reports of using FOLFOXIRI in pregnant women with metastatic and nonmetastatic CRC.…”

Section: Discussionmentioning

confidence: 99%

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FOLFOXIRI in Pregnant Women with Colorectal Cancer: A Case Report and Review of the Literature

et al. 2022

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Colorectal cancer (CRC) in pregnancy is rare and often presents at a late stage due to the masking of signs by pregnancy. A typical chemotherapeutic regimen for stage III and IV CRC comprised 5-Fluorouracil (5-FU) and oxaliplatin. The treatment of CRC during pregnancy is complicated owing to the potential risk of teratogenicity with chemotherapy, especially in the first trimester. Data suggest that the administration of chemotherapy beyond the first trimester may be relatively safe. Previous reports have shown success with the use of FOLFOX (folinic acid, 5-FU, oxaliplatin) and FOLFIRI (folinic acid, 5-FU, irinotecan) during pregnancy. Moreover, neoadjuvant FOLFOXIRI (folinic acid, 5-FU, oxaliplatin, irinotecan) resulted in improved outcomes when compared to standard preoperative chemoradiotherapy in the treatment of locally advanced and metastatic CRC. The use of FOLFOXIRI in pregnancy is not currently documented, and therefore, the outcomes of using this chemotherapeutic regimen are unclear. The aim of this case report was to demonstrate the use of FOLFOXIRI in pregnancy. A retrospective chart review was performed to assess the clinical course and fetal outcome of 2 patients presented in this case report. FOLFOXIRI was initiated in two pregnant women with nonmetastatic and metastatic CRC, resulting in successful delivery of healthy infants. FOLFOXIRI is an effective chemotherapy regimen for the treatment of advanced CRC and may be used during the second and third trimesters of pregnancy.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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FOLFOXIRI in Pregnant Women with Colorectal Cancer: A Case Report and Review of the Literature

et al. 2022

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Improvements in Clinical Trials Information Will Improve the Reproductive Health and Fertility of Cancer Patients

Dauti

Gerstl

Chong

et al. 2017

Journal of Adolescent and Young Adult Oncology

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There are a number of barriers that result in cancer patients not being referred for oncofertility care, which include knowledge about reproductive risks of antineoplastic agents. Without this information, clinicians do not always make recommendations for oncofertility care. The objective of this study was to describe the level of reproductive information and recommendations that clinicians have available in clinical trial protocols regarding oncofertility management and follow-up, and the information that patients may receive in clinical trials patient information sheets or consent forms. A literature review of the 71 antineoplastic drugs included in the 68 clinical trial protocols showed that 68% of the antineoplastic drugs had gonadotoxic animal data, 32% had gonadotoxic human data, 83% had teratogenic animal data, and 32% had teratogenic human data. When the clinical trial protocols were reviewed, only 22% of the protocols reported the teratogenic risks and 32% of the protocols reported the gonadotoxic risk. Only 56% of phase 3 protocols had gonadotoxic information and 13% of phase 3 protocols had teratogenic information. Nine percent of the protocols provided fertility preservation recommendations and 4% provided reproductive information in the follow-up and survivorship period. Twenty-six percent had a section in the clinical trials protocol, which identified oncofertility information easily. When gonadotoxic and teratogenic effects of treatment were known, they were not consistently included in the clinical trial protocols and the lack of data for new drugs was not reported. Very few protocols gave recommendations for oncofertility management and follow-up following the completion of cancer treatment. The research team proposes a number of recommendations that should be required for clinicians and pharmaceutical companies developing new trials.

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Treatment of Metastatic Colorectal Cancer in a Pregnant Woman with Lynch Syndrome- A Case Report

Cited by 2 publications

References 27 publications

FOLFOXIRI in Pregnant Women with Colorectal Cancer: A Case Report and Review of the Literature

FOLFOXIRI in Pregnant Women with Colorectal Cancer: A Case Report and Review of the Literature

Improvements in Clinical Trials Information Will Improve the Reproductive Health and Fertility of Cancer Patients

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