Breast cancer and pregnancy: how safe is trastuzumab?

Abstract

Cessation of trastuzumab and close monitoring of mother and fetus during pregnancy.

Treatment of cancer during pregnancy with monoclonal antibodies: a real challenge

“…Patients who were exposed to trastuzumab for more than one trimester (i.e., prolonged exposure) were associated with the highest risk of complications, while those who got pregnant during drug administration and discontinued the drug once pregnancy was diagnosed did not seem to be at a considerable risk [40,50,51].…”

“…In this setting, trastuzumab should be stopped and we believe that pregnancy could be allowed to continue without promotion for abortion for those patients who are willing to preserve their pregnancy. Only three patients were reported to adopt this approach with no pregnancy complications observed at all [40,50,51]. There are ongoing efforts to collect the pregnancy events observed in the large adjuvant trastuzumab studies (~10,000 randomized patients) to better define the complications observed when patients unintentionally became pregnant during the course of therapy.…”

“…To date, a total of 15 breast cancer patients have been reported to have been exposed to trastuzumab during pregnancy [40][41][42][43][44][45][46][47][48][49][50][51][52][53]. In four cases, the patients elected to receive trastuzumab following the first trimester (i.e., the period of organogenesis) [42,43,45,51].…”

Fetal Renal Insufficiency Following Trastuzumab Treatment for Breast Cancer in Pregnancy: Case Report und Review of the Current Literature

“…Each pregnancy resulted in the birth of a healthy baby [67][68][69]. Another case described a pregnancy exposed to trastuzumab until 24 weeks of gestation.…”

Antiblastic Treatment and Haematological Malignancies during Pregnancy: A Crucial Decision

“…Multi agent AC or high dose of a single drug increase this risk. Data regarding the experience with the different anti-cancer drug that are more commonly used during pregnancy are presented in Table I (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22). For more details the reader is referred to the CCOPE database (www.motherisk.org).…”