Weekly Paclitaxel for Pregnancy Associated Breast Cancer.

Cancer in pregnancy Chemotherapy safety profile in pregnancy Obstetric ouctomes Pregnancy associated breast cancer Taxanes during pregnancy

Journal

Clinical breast cancer
ISSN: 1938-0666
Titre abrégé: Clin Breast Cancer
Pays: United States
ID NLM: 100898731

Informations de publication

Date de publication:
13 Dec 2023
Historique:
received: 19 02 2023
revised: 19 09 2023
accepted: 20 11 2023
medline: 12 1 2024
pubmed: 12 1 2024
entrez: 11 1 2024
Statut: aheadofprint

Résumé

Pregnancy associated breast cancer is the most common cancer diagnosed during pregnancy. When chemotherapy is indicated, although it is more common to use anthracycline-based chemotherapy as a first treatment, we suggest weekly paclitaxel as a valid alternative both in the adjuvant and neoadjuvant setting, as this allows for weekly assessment of maternal-fetal well-being and a quicker maternal and fetal bone marrow recovery in cases of unexpected preterm delivery. We present a case series of pregnant breast cancer patients treated with weekly paclitaxel between 2016 and 2022. Patient demographics and tumor characteristics, data on management, delivery, and maternal-neonatal outcomes were extrapolated from institutional electronic databases. Eighteen patients underwent weekly paclitaxel for breast cancer during pregnancy (PrBC); 17 were primary diagnoses and 1 was a recurrence. None of the patients had severe adverse reactions to CT. Two cases of preterm prelabour rupture of membranes were reported while in 1 case treatment was stopped due to threatened preterm birth. Two babies were born large for gestational age, 2 were small for gestational age and 2 babies were growth restricted at birth. At a mean follow up of 42.9 months, 1 patient died, 1 patient was diagnosed with disease recurrence and another patient was diagnosed with disease progression. Weekly paclitaxel can be safely administered during pregnancy and should be included in the current therapeutic options for PrBC.

Sections du résumé

BACKGROUND BACKGROUND
Pregnancy associated breast cancer is the most common cancer diagnosed during pregnancy. When chemotherapy is indicated, although it is more common to use anthracycline-based chemotherapy as a first treatment, we suggest weekly paclitaxel as a valid alternative both in the adjuvant and neoadjuvant setting, as this allows for weekly assessment of maternal-fetal well-being and a quicker maternal and fetal bone marrow recovery in cases of unexpected preterm delivery.
PATIENTS AND METHODS METHODS
We present a case series of pregnant breast cancer patients treated with weekly paclitaxel between 2016 and 2022. Patient demographics and tumor characteristics, data on management, delivery, and maternal-neonatal outcomes were extrapolated from institutional electronic databases.
RESULTS RESULTS
Eighteen patients underwent weekly paclitaxel for breast cancer during pregnancy (PrBC); 17 were primary diagnoses and 1 was a recurrence. None of the patients had severe adverse reactions to CT. Two cases of preterm prelabour rupture of membranes were reported while in 1 case treatment was stopped due to threatened preterm birth. Two babies were born large for gestational age, 2 were small for gestational age and 2 babies were growth restricted at birth. At a mean follow up of 42.9 months, 1 patient died, 1 patient was diagnosed with disease recurrence and another patient was diagnosed with disease progression.
CONCLUSION CONCLUSIONS
Weekly paclitaxel can be safely administered during pregnancy and should be included in the current therapeutic options for PrBC.

Identifiants

pubmed: 38212190
pii: S1526-8209(23)00302-6
doi: 10.1016/j.clbc.2023.11.007
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2023. Published by Elsevier Inc.

Déclaration de conflit d'intérêts

Disclosure The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Auteurs

Serena Girardelli (S)

Obstetrics and Gynecology Department, I.R.C.C.S. San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy. Electronic address: girardelli.serena@hsr.it.

Barbara Bonomo (B)

Gynecologic Oncology Department, European Institute of Oncology IRCCS, Milan, Italy.

Margherita Papale (M)

Obstetrics and Gynecology Department, I.R.C.C.S. San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy.

Eugenia di Loreto (E)

Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.

Elena Grossi (E)

Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.

Giovanna Scarfone (G)

Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.

Emanuela Rabaiotti (E)

Obstetrics and Gynecology Department, I.R.C.C.S. San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy.

Luca Valsecchi (L)

Obstetrics and Gynecology Department, I.R.C.C.S. San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy.

Giorgia Mangili (G)

Obstetrics and Gynecology Department, I.R.C.C.S. San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy.

Massimo Candiani (M)

Obstetrics and Gynecology Department, I.R.C.C.S. San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy.

Fedro Peccatori (F)

Gynecologic Oncology Department, European Institute of Oncology IRCCS, Milan, Italy.

Classifications MeSH