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Breast Cancer During Pregnancy Can Be Treated as in Nonpregnant Women

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Direction of Future Research

Future studies should address not just the toxic effects of chemotherapy during pregnancy but also the pharmacokinetics of cytotoxic agents in pregnant women, because the physiologic changes of pregnancy can greatly affect drug disposition, said Dr. Olivier Mir and Dr. Paul Berveiller.

"Whether doses should be increased in this population is uncertain because such increases could result in severe thrombocytopenia, neutropenia, and infection, with potentially devastating consequences for both mother and baby," they noted.

More research also is needed to determine whether the slightly increased fetal risks identified by Dr. Loibl and her colleagues could be minimized with better drug selection and dosing, they added.

Dr. Mir and Dr. Berveiller are in the Cancer Associated With Pregnancy Network, Paris. Dr. Mir is also in the department of medical oncology at Hôpital Cochin at the Université René Descartes, Paris. Dr. Mir reported ties to Roche, Pfizer, and Servier. These remarks were taken from their editorial comment accompanying Dr. Loibl’s report (Lancet Oncol. 2012 Aug. 15 [doi:10.1016/S1470-2045(12)70331-5]).


 

FROM THE LANCET ONCOLOGY

In addition, the cytotoxic agents themselves may have hastened labor through some as yet unknown mechanism. However, the rate of preeclampsia was similar between the two groups, so oxidative stress, which is known to be induced by cytoxic agents, was not responsible.

Further study of the data being collected in the registries of cancers diagnosed during pregnancy will likely shed light on these issues. Dr. Loibl and her colleagues are now performing a matched-pair analysis to assess whether the prognosis of breast cancer in nonpregnant women differs from that in pregnant women when the latter are treated according to current guidelines.

This study was supported by BANSS Foundation, University Hospital Frankfurt, the German Breast Group, Research Foundation-Flanders, Clinical Research Fund-UZ Gasthuisberg, and the Belgian Cancer Plan. No financial conflicts of interest were reported.

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