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Approaching cancer during pregnancy

Nature Reviews Cancer volume 24, pages 159–160 (2024)Cite this article

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The concurrence of cancer and pregnancy can pose complex medical, psychosocial and ethical issues for patients and their loved ones, as well as for their healthcare team. In a patient with cancer who is pregnant, management decisions must consider any additional risks to the patient due to their pregnant state, and the risks to the foetus. These are often dependent on the gestational age, with limited data to provide information on the risks. Furthermore, if pregnancy termination is desired either due to patient preference or to optimize cancer outcomes, accessibility of reproductive health services may complicate options. Here we outline approaches to manage cancer during pregnancy with a focus on patient preferences, patient and fetal risks, and team-based clinical management.

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Fig. 1: Recommendations for cancer treatment during pregnancy.

References

  1. Ugai, T. et al. Is early-onset cancer an emerging global epidemic? Current evidence and future implications. Nat. Rev. Clin. Oncol. 19, 656–673 (2022).

    Article  PubMed  PubMed Central  Google Scholar 

  2. United Nations Economic Commission for Europe (UNECE) Statistical Database. Mean age of women at birth of first child. UNECE https://w3.unece.org/PXWeb/en/Table?IndicatorCode=34 (accessed 16 October 2023).

  3. Cottreau, C. M. et al. Pregnancy-associated cancer: A U.S. population-based study. J. Womens Health (Larchmt) 28, 250–257 (2019).

    Article  PubMed  Google Scholar 

  4. Cairncross, Z. F. et al. Long-term mortality in individuals diagnosed with cancer during pregnancy or postpartum. JAMA Oncol. 9, 791–799 (2023).

    Article  PubMed  Google Scholar 

  5. Lenaerts, L. et al. Comprehensive genome-wide analysis of routine non-invasive test data allows cancer prediction: A single-center retrospective analysis of over 85,000 pregnancies. EClinicalMedicine 35, 100856 (2021).

    Article  PubMed  PubMed Central  Google Scholar 

  6. Sorouri, K., Loren, A. W., Amant, F. & Partridge, A. H. Patient-centered care in the management of cancer during pregnancy. Am. Soc. Clin. Oncol. Educ. Book 43, e100037 (2023).

    Article  PubMed  Google Scholar 

  7. Amant, F. et al. Pediatric outcome after maternal cancer diagnosed during pregnancy. N. Engl. J. Med. 373, 1824–1834 (2015).

    Article  CAS  PubMed  Google Scholar 

  8. Amant, F. et al. Gynecologic cancers in pregnancy: guidelines based on a third international consensus meeting. Ann. Oncol. 30, 1601–1612 (2019).

    Article  CAS  PubMed  Google Scholar 

  9. Mayr, N. A., Wen, B. C. & Saw, C. B. Radiation therapy during pregnancy. Obstet. Gynecol. Clin. North Am. 25, 301–321 (1998).

    Article  CAS  PubMed  Google Scholar 

  10. van Gerwen, M. et al. Association of chemotherapy timing in pregnancy with congenital malformation. JAMA Netw. Open 4, e2113180 (2021).

    Article  PubMed  PubMed Central  Google Scholar 

  11. Maggen, C. et al. Impact of chemotherapy during pregnancy on fetal growth. J. Matern. Fetal Neonatal Med. 35, 10314–10323 (2022).

    Article  CAS  PubMed  Google Scholar 

  12. Korakiti, A. M. et al. Long-term neurodevelopmental outcome of children after in utero exposure to chemotherapy. Cancers (Basel) 12, 3623 (2020).

    Article  PubMed  Google Scholar 

  13. Wolters, V. et al. Management of pregnancy in women with cancer. Int. J. Gynecol. Cancer 31, 314–322 (2021).

    Article  PubMed  PubMed Central  Google Scholar 

  14. La Nasa, M., Gaughan, J. & Cardonick, E. Incidence of neonatal neutropenia and leukopenia after in utero exposure to chemotherapy for maternal cancer. Am. J. Clin. Oncol. 42, 884 (2019).

    Article  PubMed  Google Scholar 

  15. Khazzaka, A., Rassy, E., Sleiman, Z., Boussios, S. & Pavlidis, N. Systematic review of fetal and placental metastases among pregnant patients with cancer. Cancer Treat. Rev. 104, 102356 (2022).

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA, USA

    Leticia Varella & Ann H. Partridge

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  1. Leticia Varella
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  2. Ann H. Partridge
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Correspondence to Leticia Varella or Ann H. Partridge.

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Competing interests

A.H.P. receives royalties from Walters Kluwer for authorship of UpToDate. L.V. declares no competing interests.

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Varella, L., Partridge, A.H. Approaching cancer during pregnancy. Nat Rev Cancer 24, 159–160 (2024). https://doi.org/10.1038/s41568-023-00647-6

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