title: Use of anticancer agents in gynecological oncology during pregnancy: a systematic review of maternal pharmacokinetics and transplacental transfer.
abstract: BACKGROUND
  Cancer affects one in a thousand pregnant women and gynecological cancers are one of the most frequent malignancies. Chemotherapy remains the cornerstone treatment for gynecological cancer. Although all chemotherapeutic agents can cross the placental barrier, the extent of placental transfer varies considerably. Furthermore, the significant physiological variations observed in pregnant women may have an impact on pharmacokinetic parameters. Given the complexity of predicting placental transfer, in vivo and ex vivo studies are essential in this context. In view of the paucity of data on chemotherapy during pregnancy, the objective of the present study was to summarize all the available data on the transplacental transfer of anticancer drugs used to treat gynecological cancers.
  
  
  METHODS
  In order to evaluate the in vivo and ex vivo transplacental transfer of the anticancer drugs most frequently used in gynecological malignancies, we carried out a comprehensive review of the literature published from 1967 to 2015. Lastly, we summarized recent clinical guidelines on the treatment of gynecological cancers in pregnant patients.
  
  
  CONCLUSIONS
  The preclinical and scarce clinical data must now be extrapolated to define the maternofetal toxicity/efficacy profile and thus guide the physicians to choose anticancer drugs more efficiently in this complex situation.
authors.affiliation: a Department of Gynecology and Obstetrics , Centre Hospitalier Intercommunal de Poissy Saint Germain , Poissy , France.|b EA7404-GIG, UFR des Sciences de la Santé , Université Versailles Saint Quentin en Yvelines , Montigny-Le-Bretonneux , France.
authors.forename: Paul
authors.initials: P
authors.lastname: Berveiller
authors.affiliation: a Department of Gynecology and Obstetrics , Centre Hospitalier Intercommunal de Poissy Saint Germain , Poissy , France.
authors.forename: Oriane
authors.initials: O
authors.lastname: Marty
authors.affiliation: b EA7404-GIG, UFR des Sciences de la Santé , Université Versailles Saint Quentin en Yvelines , Montigny-Le-Bretonneux , France.|c Department of Cytogenetics , Centre Hospitalier Intercommunal de Poissy Saint Germain , Poissy , France.
authors.forename: François
authors.initials: F
authors.lastname: Vialard
authors.affiliation: d Department of Cancer Medicine , Gustave Roussy Cancer Campus , Villejuif , France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Mir
mesh_terms: D000818:Animals; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000627:therapeutic use*; D005260:Female; D005833:Genital Neoplasms, Female / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D008431:Maternal-Fetal Exchange; D009369:Neoplasms; D010920:Placenta / Q000378:metabolism; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000188:drug therapy*
chemical_list: D000970:Antineoplastic Agents
keywords: Anticancer agent; cancer; placenta; pregnancy; transplacental transfer