Transplacental Passage and Fetal Effects of Antineoplastic Treatment during Pregnancy

Simple Summary In this paper we perform an introduction about pregnancy-associated cancer (PAC) and transplacental passage of antineoplastic agents. Furthermore, we describe therapeutic use and potential toxic effects of chemotherapeutic drug (alkylating agents, antimetabolites agents, anthracyclines, topoisomerase inhibitors, antimitotic agents, actinomycin-D, bleomycin) and targeted agents during pregnancy. This manuscript may be a useful and practical guide for the management of PAC, which is a challenge for clinicians that have to consider alike maternal benefits and fetal potential risks correlated to the antineoplastic treatment. The incidence of PAC is relatively infrequent among pregnant women. However, it has gradually increased in recent years, becoming a challenging area for clinicians that should take into account in the same way maternal benefits and fetal potential risks correlated to the antineoplastic treatment. None of the antineoplastic drugs is completely risk-free during the pregnancy, the timing of exposure and transplacental transfer properties influence the toxicity of the fetus. Despite the lack of guidelines about the management of PAC, several studies have described the use and the potential fetal and neonatal adverse events of antineoplastic drugs during pregnancy. We provide a review of the available literature about the transplacental passage and fetal effects of chemotherapy and targeted agents, to guide the clinicians in the most appropriate choices for the management of PAC.

Automated summary

This paper provides an overview of pregnancy-associated cancer (PAC) and the transplacental passage of antineoplastic agents. It discusses the therapeutic use and potential toxic effects of various chemotherapy drugs and targeted agents during pregnancy. The management of PAC is challenging for clinicians as they need to consider both maternal benefits and potential fetal risks associated with antineoplastic treatment. Although PAC is relatively rare among pregnant women, its incidence has been gradually increasing in recent years. None of the antineoplastic drugs are completely risk-free during pregnancy, and the timing of exposure and transplacental transfer properties can influence fetal toxicity. Despite the lack of guidelines, several studies have described the use and potential adverse events of antineoplastic drugs in pregnancy. This review aims to guide clinicians in making appropriate treatment choices for PAC.