Treatment of lung cancer during pregnancy

Soares, A.; Santos, Joana Dos; Silva, A.; Magalhães, Helena; Estevinho, F.; Sottomayor, C.

doi:10.1016/j.pulmoe.2020.05.004

Cited by 5 publications

(3 citation statements)

References 27 publications

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“… 16 , 17 , 18 In addition, cases where immunotherapy was administered exclusively before the gestational period or postpartum were also excluded. 19 , 20 , 21 , 22 From each one of those studies, the following data were extracted: first author, year of publication, type of immunotherapy administered during pregnancy, type of malignancy, patient age at diagnosis, patient age at pregnancy, gestational age (GA) at immunotherapy administration, total dose administered, GA at delivery, way of delivery (Cesarean section, etc. ), fetal outcome [prematurity, respiratory distress syndrome (RDS), congenital abnormalities etc.…”

Section: Methodsmentioning

confidence: 99%

Immune checkpoint inhibitor administration during pregnancy: a case series

et al. 2021

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Background: Immune checkpoint inhibitors have been widely implemented in current clinical practice. Although cancer occurs in w1 out of 1000 pregnancies, treatment remains challenging. Until now, limited data exist regarding immunotherapy administration during pregnancy. This systemic review aims to synthesize all available data from immunotherapy administration in pregnant women and evaluate the efficacy and safety of immunotherapy during pregnancy. Patients and methods: Eligible studies were identified by a search of the PubMed Medline database and Food and Drug Administration Adverse Events Reporting System Public Dashboard for the period 1 January 2000 to 1 April 2021; the algorithm consisted of a predefined combination of the words 'immunotherapy', 'cancer' and 'pregnancy'. PRISMA guidelines were applied in this study. Results: Overall, seven articles (seven pregnancies, nine neonates) were retrieved. The mean duration of immunotherapy administration was 9.8 weeks [standard deviation (SD): 11.27; median: 7.0; range: 1-32]. In all cases specified, melanoma was the malignancy reported. The mean gestational age at delivery was 30.4 weeks (SD: 5.03; median: 32.0; range: 24-38), whereas the mean weight of neonates at delivery was 1267 g (SD: 412.0; median: 1400; range: 590-1701). Only one neonate was born term at 38 weeks of pregnancy (11.1%; 1/9). Complications during pregnancy were observed in 71.4% of cases: intrauterine growth restriction (three cases), HELLP syndrome (hemolysis, elevated liver enzymes, low platelet count) (one case), placental insufficiency (one case) and low fetal heart rate (one case). The mean progression-free survival and overall survival were 16.0 and 25.2 months, respectively. Conclusion:The administration of immune checkpoint inhibitors during pregnancy is associated with increased incidence of pregnancy complications, prematurity and low birth weight. The administration of these regimens is not recommended during gestation. Whenever applied, close monitoring of the mother and the fetus is required.

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Section: Methodsmentioning

confidence: 99%

Immune checkpoint inhibitor administration during pregnancy: a case series

et al. 2021

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“…Cancer-specific clinical practice guidelines also provide current best practice procedures and treatments for women diagnosed with different cancers (e.g. gynaecological cancer [ 28 ], haematological [ 29 ], breast [ 30 ], lung [ 31 ]). Transparent communications with families regarding consultation of these guidelines may bolster confidence in clinicians.…”

Section: Discussionmentioning

confidence: 99%

Experiences of cohabiting partners of women diagnosed with cancer during pregnancy: a qualitative study

Sinclair,

Song,

Peate

et al. 2024

Support Care Cancer

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Purpose When a pregnant woman is diagnosed with cancer, she faces complex and unique challenges while navigating both obstetric and oncological care. Despite often being the primary support for women diagnosed with cancer during pregnancy (CDP), little is known about the experiences of their partners. We undertook an in-depth exploration of the experiences of partners of women diagnosed with CDP in Australia. Methods Semi-structured interviews were conducted with partners of women diagnosed with CDP treated in Australia. Interviews explored partners’ inclusion in decision making and communication with health professionals and their own coping experiences. Data were analysed thematically. Results Data from interviews with 12 male partners (N = 12) of women diagnosed with CDP were analysed. Two unique themes relevant to partners were identified: ‘Partners require support to adjust to changing roles and additional burdens’ and ‘Treating the couple as a team facilitates agency and coping, but partners’ needs are placed second by all’. Conclusion Partners of women diagnosed with CDP commonly experience unique stressors and a substantial shift in previously established roles across multiple domains including medical advocacy, household coordination and parenting. Partners’ coping is interlinked with how the woman diagnosed with CDP is coping. Inclusion of partners in treatment decisions and communications, and considering partners’ wellbeing alongside that of the woman with CDP, is likely to be supportive for partners. In turn, this is likely to enhance the quality of support that women diagnosed with CDP receive from their partners.

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“…Lung cancer [31,32] Chemotherapy (second and third trimester), targeted therapies-only limited data available due to rarity of the condition Increased risk of lung infections. Case reports suggest that lung cancer is diagnosed at advanced stages in pregnancy and prognosis is poor.…”

Section: Relationship Between Pregnancymentioning

confidence: 99%

Caring for Pregnant Patients with Cancer: A Framework for Ethical and Patient-Centred Care

Linkeviciute,

Canario,

Peccatori

et al. 2024

Cancers

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(1) Background: Caring for pregnant cancer patients is clinically and ethically complex. There is no structured ethical guidance for healthcare professionals caring for these patients. (2) Objective: This concept paper proposes a theoretically grounded framework to support ethical and patient-centred care of pregnant cancer patients. (3) Methodological approach: The framework development was based on ethical models applicable to cancer care during pregnancy—namely principle-based approaches (biomedical ethics principles developed by Beauchamp and Childress and the European principles in bioethics and biolaw) and relational, patient-focused approaches (relational ethics, ethics of care and medical maternalism)—and informed by a systematic review of clinical practice guidelines. (4) Results: Five foundational discussion themes, summarising the key ethical considerations that should be taken into account by healthcare professionals while discussing treatment and care options with these patients, were identified. This was further developed into a comprehensive ethics checklist that can be used during clinical appointments and highlights the need for a holistic view to patient treatment, care and counselling while providing ethical, patient-centric care. (5) Conclusion: The proposed framework was further operationalised into an ethics checklist for healthcare professionals that aims to help them anticipate and address ethical concerns that may arise when attending to pregnant cancer patients. Further studies exploring clinicians’ attitudes towards cancer treatment in the course of pregnancy and patient experiences when diagnosed with cancer while pregnant and wider stakeholder engagement are needed to inform the development of further ethical, patient-centred guidance.

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Treatment of lung cancer during pregnancy

Cited by 5 publications

References 27 publications

Immune checkpoint inhibitor administration during pregnancy: a case series

Immune checkpoint inhibitor administration during pregnancy: a case series

Experiences of cohabiting partners of women diagnosed with cancer during pregnancy: a qualitative study

Caring for Pregnant Patients with Cancer: A Framework for Ethical and Patient-Centred Care

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