title: Targeted agents for cancer treatment during pregnancy.
abstract: The last decade has witnessed important advances in the field of managing cancer during pregnancy. However, still limited data is available on the safety of administering targeted agents in pregnant cancer patients. Given the increasing use of targeted agents in clinical practice, it is becoming vital to properly understand how far they can be used in a pregnant patient without compromising the outcome of the fetus. Unlike chemotherapy, monoclonal antibodies are large molecules that require active transport via the placenta to reach the fetus. On the other hand, similarly to chemotherapy, small molecules like tyrosine kinase inhibitors (TKIs) can cross the placenta throughout the pregnancy period. The majority of targeted agents have worrying preclinical data discouraging their use during pregnancy. Multi-TKIs are of particular concern given their potential interference with other vital physiological functions that could be necessary in fetal development. Yet this does not mean that all targeted agents should be avoided completely during pregnancy. The current review provides a critical evaluation on all targeted agents that are currently in clinical use and provides a guide in order to help clinicians counseling their pregnant cancer patients.
authors: Department of Medical Oncology, UO Oncologia Medica 2, IRCCS AOU San Martino-IST, Genoa, Italy.
authors: Matteo
authors: M
authors: Lambertini
authors: Fertility and Procreation Unit, Gynecologic Oncology Department, European Institute of Oncology, Milan, Italy.
authors: Fedro A
authors: FA
authors: Peccatori
authors: BrEAST Data Centre, Department of Medicine, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium. Electronic address: hatem.azim@bordet.be.
authors: Hatem A
authors: HA
authors: Azim
mesh_terms: D000818:Animals; D000911:Antibodies, Monoclonal / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D058990:Molecular Targeted Therapy; D009369:Neoplasms / Q000188:drug therapy*; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000188:drug therapy*; D047428:Protein Kinase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D000911:Antibodies, Monoclonal; D047428:Protein Kinase Inhibitors
keywords: Abortion; Biological agents; Cancer during pregnancy; Malformation; Monoclonal antibodies; Safety; Targeted agents; Tyrosine kinase inhibitors