How much platinum passes the placental barrier? Analysis of platinum applications in 21 patients with cervical cancer during pregnancy

Köhler, Christian; Oppelt, Peter; Favero, Giovanni; Morgenstern, Bernd; Runnebaum, I. B.; Tsunoda, Audrey Tieko; Schmittel, Alexander; Schneider, Achim; Mueller, Martin; Marnitz, Simone

doi:10.1016/j.ajog.2015.02.022

Cited by 64 publications

(53 citation statements)

References 39 publications

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“…Platinum-based chemotherapy seems to be the most active8; outside of pregnancy, it is the most applied therapy in cervical cancer patients 9 10. It has been reported that 11–42% of cisplatin crosses the placental barrier 11. Ototoxicity of cisplatin was reported in one case 12.…”

Section: Discussionmentioning

confidence: 94%

Characteristics of patients with cervical cancer during pregnancy: a multicenter matched cohort study. An initiative from the International Network on Cancer, Infertility and Pregnancy

Halaška

Uzan²,

Han

et al. 2019

Int J Gynecol Cancer

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BackgroundTreatment of cervical cancer during pregnancy is often complex and challenging. This study aimed to analyze current patterns of practice in the management of pregnant patients diagnosed with cervical cancer.MethodsThis was a matched cohort study comprising patients managed for cervical cancer during pregnancy from six European centers. Patient information was retrieved from the dataset of the International Network for Cancer, Infertility and Pregnancy from 1990 to 2012. Each center matched its patients with two non-pregnant controls for age (±5 years) and International Federation of Gynecology and Obstetrics (FIGO) 2009 stage. Information on age, histological type, grade, lymphovascular space invasion, stage, tumor size, method of diagnosis, site of recurrence, delivery, date of recurrence, and date of death was recorded. Progression-free survival was compared using multivariable Cox proportional hazards regression.ResultsA total of 132 pregnant patients and 256 controls were analyzed. The pregnant patients (median age 34 years, range 21–43) were diagnosed at a median gestational age of 18.4 weeks of pregnancy (range 7–39). Stage distribution during pregnancy was 14.4% for stage IA, 47.0% for IB1, 18.9% for IB2, and 19.7% for II-IV. For treatment during pregnancy, 17.4% of the patients underwent surgery, 16.7% received neoadjuvant chemotherapy, 26.5% delayed their treatment, 12.9% had a premature delivery, and 26.5% had their pregnancy terminated. Median follow-up was 84 months (67 months for pregnant and 95 months for non-pregnant patients). The unadjusted hazard ratio of pregnancy for progression-free survival was 1.18 (95% confidence interval 0.74 to 1.88).ConclusionSurgery and chemotherapy is increasingly used in the management of pregnant patients with cervical cancer and prognosis is similar to that of non-pregnant patients.

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Section: Discussionmentioning

confidence: 94%

Characteristics of patients with cervical cancer during pregnancy: a multicenter matched cohort study. An initiative from the International Network on Cancer, Infertility and Pregnancy

Halaška

Uzan²,

Han

et al. 2019

Int J Gynecol Cancer

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“…The prenatal platinum exposure has been associated with ototoxicity [16][17][18][19][20][21] and fetal growth restriction [22]. Up to now, only 3 cases were treated with carboplatin to the best of our knowledge [6,23,24]. No fetal and neonatal complications concerning carboplatin has been reported.…”

Section: Discussionmentioning

confidence: 99%

A case of successful maintained pregnancy after neoadjuvant chemotherapy plus radical surgery for stage IB3 cervical cancer diagnosed at 13 weeks

Guo

Zhang

et al. 2020

BMC Pregnancy Childbirth

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Background: Cervical cancer during pregnancy is rare. The management for stage IB3 during pregnancy remains unclear and challenging. We report a successful preserved pregnancy in a stage IB3 patient who was treated with neoadjuvant chemotherapy (NACT) plus radical surgery. Case presentation: A 36-year-old pregnant woman was diagnosed with a 5-cm-diameter stage IB3 squamous cell carcinoma of the uterine cervix at 13 gestational weeks. The patient received 5 courses of systemic chemotherapy with carboplatin and paclitaxel every 3 weeks, followed by caesarean section and radical hysterectomy. Both the mother and infant are in good general condition. Conclusion: This case suggests that NACT plus radical surgery could be one method to maintain pregnancy in stage IB3 cervical cancer diagnosed as early as 13 gestational weeks.

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“…These results have been confirmed by a larger and more recent study from the same authors. 12 However, they emphasize in both studies that a long-term oncologic and pediatric follow-up is essential to confirm the safety of this practice.…”

Section: Use Of Platinum Compounds and Taxanes In Pregnancymentioning

confidence: 99%

Locally Advanced Cervical Cancer in Pregnancy: Overcoming the Challenge. A Case Series and Review of the Literature

Ricci

Scambia

Vincenzo

2016

Int J Gynecol Cancer

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How much platinum passes the placental barrier? Analysis of platinum applications in 21 patients with cervical cancer during pregnancy

Cited by 64 publications

References 39 publications

Characteristics of patients with cervical cancer during pregnancy: a multicenter matched cohort study. An initiative from the International Network on Cancer, Infertility and Pregnancy

Characteristics of patients with cervical cancer during pregnancy: a multicenter matched cohort study. An initiative from the International Network on Cancer, Infertility and Pregnancy

A case of successful maintained pregnancy after neoadjuvant chemotherapy plus radical surgery for stage IB3 cervical cancer diagnosed at 13 weeks

Locally Advanced Cervical Cancer in Pregnancy: Overcoming the Challenge. A Case Series and Review of the Literature

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