title: Doxorubicin and ifosfamide for high-grade sarcoma during pregnancy.
abstract: OBJECTIVE
  Doxorubicin and ifosfamide are highly active drugs for the treatment of high-grade sarcomas, but little is known on the optimal management of young patients who develop such malignancies during pregnancy.
  
  
  METHODS
  We report on a single-institution series of patients (n = 9) with high-grade sarcoma diagnosed during the third trimester of pregnancy. Neoadjuvant chemotherapy combining doxorubicin (50 mg/m(2) day 1) and ifosfamide (2.5 g/m(2) days 1-2) with standard mesna rescue every 3 weeks was administered during the third trimester of pregnancy in five patients.
  
  
  RESULTS
  We observed a favourable outcome for both the mother and the offspring in all cases. Maternal and neonatal pharmacokinetic data for ifosfamide were obtained from one patient and did not evidence a transplacental transfer of this drug. The use of other active drugs (cisplatin, etoposide, dactinomycin and cyclophosphamide) in sarcoma during pregnancy is discussed on the basis of a comprehensive review of the English literature.
  
  
  CONCLUSIONS
  In view of this single-centre experience, we suggest that the treatment of high-grade sarcoma during the third trimester of pregnancy should include an adapted regimen tailored to the pharmacological specificities of the pregnant patients.
authors.affiliation: Department of Medicine, Sarcoma Unit, Herault Ward, Institut Gustave Roussy, Paris Sud University, 39, rue Camille Desmoulins, 94800 Villejuif cedex, France. olivier.mir@cch.aphp.fr
authors.forename: Olivier
authors.initials: O
authors.lastname: Mir
authors.forename: Narjiss
authors.initials: N
authors.lastname: Berrada
authors.forename: Julien
authors.initials: J
authors.lastname: Domont
authors.forename: Angela
authors.initials: A
authors.lastname: Cioffi
authors.forename: Bérénice
authors.initials: B
authors.lastname: Boulet
authors.forename: Philippe
authors.initials: P
authors.lastname: Terrier
authors.forename: Sylvie
authors.initials: S
authors.lastname: Bonvalot
authors.forename: Caroline
authors.initials: C
authors.lastname: Trichot
authors.forename: François
authors.initials: F
authors.lastname: Lokiec
authors.forename: Axel
authors.initials: A
authors.lastname: Le Cesne
mesh_terms: D000328:Adult; D000505:Alopecia / Q000139:chemically induced; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D004317:Doxorubicin / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics; D007231:Infant, Newborn; D009503:Neutropenia / Q000139:chemically induced; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D011256:Pregnancy Outcome; D011263:Pregnancy Trimester, Third; D012509:Sarcoma / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D004317:Doxorubicin; D007069:Ifosfamide