Taxanes during Pregnancy: Probably Safe, but Still to Be Optimized

Berveiller, Paul; Mir, Olivier

doi:10.1159/000341820

Cited by 26 publications

(17 citation statements)

References 26 publications

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“…Perhaps the largest study of a single regimen was of 5‐fluourouracil, doxorubicin, and cyclophosphamide) . Data with other regimens and other classes of chemotherapy agents, including taxanes and platinum agents, are more limited (Table ). Specifically, fetal outcomes, although generally favorable after taxane and/or platinum therapy, are based on a relatively small number of carefully selected patients with relatively limited follow‐up; thus, bias may be an issue.…”

Section: Systemic Therapymentioning

confidence: 99%

Multidisciplinary Management of Breast Cancer During Pregnancy

et al. 2017

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To maximize benefit and minimize risk to the mother and fetus, an informed discussion with the patient and her medical team should result in an individualized treatment plan, taking into account the timing of the pregnancy and the stage and subtype of the breast cancer. Because BCDP is rare, it is essential to collect patient data in international registries. 2017;22:324-334 IMPLICATIONS FOR PRACTICE: Breast cancer during pregnancy is a major ethical and professional challenge for both the patient and the multidisciplinary treatment team. Although the oncologic care is based on that of the non-pregnant breast cancer patient, there are many challenges from regarding the medical, surgical and radiation oncology and obstetrical aspects of care that need to be considered to deliver the safest and best treatment plan to both the mother and developing fetus.

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Section: Systemic Therapymentioning

confidence: 99%

Multidisciplinary Management of Breast Cancer During Pregnancy

et al. 2017

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“…Moreover, only ex vivo data are available on the transplacental transfer of taxanes in humans; whereas, in a human placental perfusion model, the transplacental transfer rate of paclitaxel was found to be low (Ͻ5%). 26 Furthermore, little is known about the optimal dosing regimen for taxanes in pregnant women with breast cancer; analysis of the data suggests that pregnant patients who receive paclitaxel had lower area under the curve and higher clearance compared with nonpregnant patients. 13,26,27 Therefore, it seems that conventional-dosing schedules may result in suboptimal exposure in pregnant women with breast cancer.…”

Section: Discussionmentioning

confidence: 99%

“…26 Furthermore, little is known about the optimal dosing regimen for taxanes in pregnant women with breast cancer; analysis of the data suggests that pregnant patients who receive paclitaxel had lower area under the curve and higher clearance compared with nonpregnant patients. 13,26,27 Therefore, it seems that conventional-dosing schedules may result in suboptimal exposure in pregnant women with breast cancer. 26 In addition, the high rate of oligohydramnios and/or anhydramnios should be mentioned.…”

Section: Discussionmentioning

confidence: 99%

Taxanes for Breast Cancer During Pregnancy: A Systematic Review

Zagouri

Sergentanis

Chrysikos

et al. 2013

Clinical Breast Cancer

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Landmark studies have established taxanes in the treatment of patients with breast cancer; however, recommendations regarding their administration during pregnancy are controversial. The present systematic review aims to synthesize all available data that stem exclusively from breast cancer case series to evaluate the efficacy and safety of taxanes during pregnancy. Overall, 16 studies (50 pregnancies) were eligible for the systematic review according to prisma guidelines. The mean age of patients with breast cancer at pregnancy was 34.6 years. The gestational age (GA) at chemotherapy administration varied from 12 to 36 weeks. The mean GA at delivery was 35.9 weeks. The mean weight of babies at delivery was 2380 g. In 76.7% of cases, a completely healthy neonate was born; in the remaining cases, a neonate who was dystrophic and premature, one with mild hydrocephalus, one with signs of bacterial sepsis, one with hyperbilirubinemia, one with apnea of prematurity, respiratory distress syndrome and gastroesophageal reflux, one with meconium-stained fluid, and another neonate with neutropenia and pyloric stenosis were reported. Ninety percent of children were completely healthy, with a median follow-up of 16 months; in the remaining cases, one child with recurrent otitis media, one with immunoglobulin A deficiency and mild constipation, and another child with delayed speech were reported. In conclusion, available data suggest that taxanes may potentially play a promising role in the optimal therapeutic strategy of patients with breast cancer diagnosed during pregnancy.

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“…34 However, adverse side effects of PTX include gastrointestinal toxicity, hypersensitivity, neurotoxicity, and myelosuppression. 51,52 The water solubility of PTX is poor, restricting its utilization and bioactivity. 21 In this study, we reported a technique for increasing both the in vitro release and in vivo safety and efficacy of LK and PTX, administered as a subcutaneous abdominal injection, using a co-loading of a LK/PTX/PEG-b-(PELGg-(PZLL-r-PLL)) complex.…”

Section: Discussionmentioning

confidence: 99%

Lumbrokinase/paclitaxel nanoparticle complex: potential therapeutic applications in bladder cancer

Yan

Tong

et al. 2018

IJN

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BackgroundLumbrokinase (LK) is an enzyme complex with antithrombotic, antioxidant, antitumor, and immunomodulatory effects. It has been extensively studied and used in clinical anti-tumor therapy. However, its half-life is short, its bioavailability is low, and its toxicity and side effects are great, which greatly limit its clinical application. Therefore, LK is often combined with other drugs (such as immune agents, hormones, or Chinese herbal medicine) to reduce its dosage and side effects and to improve its anti-tumor effects.Methods and resultsHere, we described an LK/paclitaxel (PTX) nanocarrier based on poly(ethylene glycol)-b-(poly(ethylenediamine l-glutamate)-g-poly(ε-benzyoxycarbonyl-l-lysine)-r-poly(l-lysine)) (PEG-b-(PELG-g-(PZLL-r-PLL))). In the present study, LK and PTX were loaded by electrostatic and/or hydrophobic effects under mild conditions, thereby increasing the half-life and bioavailability of the drugs via the sustained release and enhancement of tumor site enrichment by the LK/PTX/PEG-b-(PELG-g-(PZLL-r-PLL)) complex through passive targeting. In this study, using bladder cancer cells (J82 cells) and rat bladder cancer model as the object, the structure of the nanocarrier, the relationship between drugs composition and antitumor properties were systematically studied.ConclusionWe propose that the block copolymer PEG-b-(PELG-g-(PZLL-r-PLL)) may function as a potent nanocarrier for augmenting anti-bladder cancer pharmacotherapy, with unprecedented clinical benefits.

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Taxanes during Pregnancy: Probably Safe, but Still to Be Optimized

Cited by 26 publications

References 26 publications

Multidisciplinary Management of Breast Cancer During Pregnancy

Multidisciplinary Management of Breast Cancer During Pregnancy

Taxanes for Breast Cancer During Pregnancy: A Systematic Review

Lumbrokinase/paclitaxel nanoparticle complex: potential therapeutic applications in bladder cancer

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