title: Antiblastic treatment, for solid tumors, during pregnancy: a crucial decision.
abstract: Cancer is the second leading cause of death during the reproductive years complicating between 0.02 percent and 0.1 percent of pregnancies. The incidence is expected to rise with the increase in age of childbearing. The most common types of pregnancy-associated cancers are: cervical cancer, breast cancer, malignant melanoma, Hodgkin's lymphoma, non-Hodgkin's lymphoma and ovarian cancer. The relatively rare occurrence of pregnancy-associated cancer precludes conducting large, prospective studies to examine diagnostic, management and outcome issues. The treatment of pregnancy-associated cancer is complex since it may be associated with adverse fatal effects. In pregnant patients diagnosed with cancer during the first trimester, treatment with multidrug anti-cancer chemotherapy is associated with an increased risk of congenital malformations, spontaneous abortions or fetal death, and therefore, should follow a strong recommendation for pregnancy termination. Second and third trimester exposure is not associated with teratogenic effect but increases the risk of intrauterine growth retardation and low birth weight. There are no sufficient data regarding the teratogenicity of most cytotoxic drugs. Almost all chemotherapeutic agents were found to be teratogenic in animals and for some drugs only experimental data exist. Moreover, no pharmacokinetic studies have been conducted in pregnant women receiving chemotherapy in order to understand whether pregnant women should be treated with different doses of chemotherapy. This article reviews the available data regarding the different aspects of the treatment of cancer during pregnancy.
authors.affiliation: Department of Medical Oncology, National Cancer Institute, Aviano (PN), Italy. mberretta@cro.it
authors.forename: M
authors.initials: M
authors.lastname: Berretta
authors.forename: R
authors.initials: R
authors.lastname: Di Francia
authors.forename: A
authors.initials: A
authors.lastname: Lleshi
authors.forename: P
authors.initials: P
authors.lastname: De Paoli
authors.forename: G
authors.initials: G
authors.lastname: Li Volti
authors.forename: A
authors.initials: A
authors.lastname: Bearz
authors.forename: L
authors.initials: L
authors.lastname: Del Pup
authors.forename: U
authors.initials: U
authors.lastname: Tirelli
authors.forename: M
authors.initials: M
authors.lastname: Michieli
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects*; D001943:Breast Neoplasms / Q000188:drug therapy; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy; D010051:Ovarian Neoplasms / Q000188:drug therapy; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology; D013274:Stomach Neoplasms / Q000188:drug therapy; D002583:Uterine Cervical Neoplasms / Q000188:drug therapy
chemical_list: D000970:Antineoplastic Agents