PURPOSE: Doxorubicin and ifosfamide are highly active drugs for the treatment of high-grade sarcomas, but little is known on the optimal management of young patients who develop such malignancies during pregnancy. METHODS: We report on a single-institution series of patients (n = 9) with high-grade sarcoma diagnosed during the third trimester of pregnancy. Neoadjuvant chemotherapy combining doxorubicin (50 mg/m(2) day 1) and ifosfamide (2.5 g/m(2) days 1-2) with standard mesna rescue every 3 weeks was administered during the third trimester of pregnancy in five patients. RESULTS: We observed a favourable outcome for both the mother and the offspring in all cases. Maternal and neonatal pharmacokinetic data for ifosfamide were obtained from one patient and did not evidence a transplacental transfer of this drug. The use of other active drugs (cisplatin, etoposide, dactinomycin and cyclophosphamide) in sarcoma during pregnancy is discussed on the basis of a comprehensive review of the English literature. CONCLUSIONS: In view of this single-centre experience, we suggest that the treatment of high-grade sarcoma during the third trimester of pregnancy should include an adapted regimen tailored to the pharmacological specificities of the pregnant patients.
PURPOSE:Doxorubicin and ifosfamide are highly active drugs for the treatment of high-grade sarcomas, but little is known on the optimal management of young patients who develop such malignancies during pregnancy. METHODS: We report on a single-institution series of patients (n = 9) with high-grade sarcoma diagnosed during the third trimester of pregnancy. Neoadjuvant chemotherapy combining doxorubicin (50 mg/m(2) day 1) and ifosfamide (2.5 g/m(2) days 1-2) with standard mesna rescue every 3 weeks was administered during the third trimester of pregnancy in five patients. RESULTS: We observed a favourable outcome for both the mother and the offspring in all cases. Maternal and neonatal pharmacokinetic data for ifosfamide were obtained from one patient and did not evidence a transplacental transfer of this drug. The use of other active drugs (cisplatin, etoposide, dactinomycin and cyclophosphamide) in sarcoma during pregnancy is discussed on the basis of a comprehensive review of the English literature. CONCLUSIONS: In view of this single-centre experience, we suggest that the treatment of high-grade sarcoma during the third trimester of pregnancy should include an adapted regimen tailored to the pharmacological specificities of the pregnant patients.
Authors: A Cubillo; S Morales; E Goñi; F Matute; J L Muñoz; D Pérez-Díaz; J de Santiago; Á Rodríguez-Lescure Journal: Clin Transl Oncol Date: 2020-11-16 Impact factor: 3.405
Authors: Bradley H Sipe; Sarah G Običan; Evita Henderson-Jackson; Nicole D Riddle; Rikesh Makanji; Ricardo J Gonzalez; Andrew S Brohl Journal: Case Rep Oncol Med Date: 2021-07-16