Obstetric and neonatal outcomes following taxane use during pregnancy: a systematic review
Abstract Background The use of taxanes following the first trimester of pregnancy is endorsed by current clinical guidelines. However, evidence regarding their safety in terms of obstetric and neonatal outcomes is limited. Methods A comprehensive literature search was performed using the MEDLINE, CE...
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| Format: | Article |
| Language: | English |
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BMC
2024-01-01
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| Series: | BMC Cancer |
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| Online Access: | https://doi.org/10.1186/s12885-023-11704-6 |
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| author | Alejandro Aranda-Gutierrez Ana S. Ferrigno Guajardo Bryan F. Vaca-Cartagena David G. Gonzalez-Sanchez Arantxa Ramirez-Cisneros Andrea Becerril-Gaitan Hatem A. Azim Cynthia Villarreal-Garza |
| author_facet | Alejandro Aranda-Gutierrez Ana S. Ferrigno Guajardo Bryan F. Vaca-Cartagena David G. Gonzalez-Sanchez Arantxa Ramirez-Cisneros Andrea Becerril-Gaitan Hatem A. Azim Cynthia Villarreal-Garza |
| author_sort | Alejandro Aranda-Gutierrez |
| collection | DOAJ |
| description | Abstract Background The use of taxanes following the first trimester of pregnancy is endorsed by current clinical guidelines. However, evidence regarding their safety in terms of obstetric and neonatal outcomes is limited. Methods A comprehensive literature search was performed using the MEDLINE, CENTRAL and Web of Sciences databases from their inception up to 12/16/2022. Eligibility criteria included gestational taxane use, presentation of original findings, and individual case data presented. A descriptive statistical analysis was undertaken. Results A total of 159 patients treated with taxane-containing regimens during pregnancy were identified, resulting in 162 fetuses exposed in utero. The majority of patients had breast cancer (n = 88; 55.3%) or cervical cancer (n = 45; 28.3%). The most commonly employed taxane was paclitaxel (n = 131; 82.4%). A total of 111 (69.8%) patients were also treated with other cytotoxic drugs during pregnancy, including platinum salts (n = 70; 63.0%) and doxorubicin/cyclophosphamide (n = 20; 18.0%). While most patients received taxanes during the second trimester of pregnancy (n = 79; 70.0%), two were exposed to taxanes in the first trimester. Obstetric outcomes were reported in 105 (66.0%) cases, with the most frequent adverse events being preterm contractions or premature rupture of membranes (n = 12; 11.4%), pre-eclampsia/HELLP syndrome (n = 6; 5.7%), and oligohydramnios/anhydramnios (n = 6; 5.7%). All cases with pregnancy outcome available resulted in live births (n = 132). Overall, 72 (54.5%) neonates were delivered preterm, 40 (30.3%) were classified as small for gestational age (SGA), and 2 (1.5%) had an Apgar score of < 7 at 5 min. Perinatal complications included acute respiratory distress syndrome (n = 14; 10.6%), hyperbilirubinemia (n = 5; 3.8%), and hypoglycemia (n = 2; 1.5%). In addition, 7 (5.3%) cases of congenital malformations were reported. At a median follow-up of 16 months, offspring health status was available for 86 (65.2%), of which 13 (15.1%) had a documented complication, including delayed speech development, recurrent otitis media, and acute myeloid leukemia. Conclusions Taxanes appear to be safe following the first trimester of pregnancy, with obstetric and fetal outcomes being similar to those observed in the general obstetric population. Future studies should aim to determine the most effective taxane regimen and dosage for use during gestation, with a specific focus on treatment safety. |
| first_indexed | 2024-03-08T16:17:43Z |
| format | Article |
| id | doaj.art-ce5ecb87ed894785993038ad10ea6024 |
| institution | Directory Open Access Journal |
| issn | 1471-2407 |
| language | English |
| last_indexed | 2024-03-08T16:17:43Z |
| publishDate | 2024-01-01 |
| publisher | BMC |
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| series | BMC Cancer |
| spelling | doaj.art-ce5ecb87ed894785993038ad10ea60242024-01-07T12:30:09ZengBMCBMC Cancer1471-24072024-01-012411810.1186/s12885-023-11704-6Obstetric and neonatal outcomes following taxane use during pregnancy: a systematic reviewAlejandro Aranda-Gutierrez0Ana S. Ferrigno Guajardo1Bryan F. Vaca-Cartagena2David G. Gonzalez-Sanchez3Arantxa Ramirez-Cisneros4Andrea Becerril-Gaitan5Hatem A. Azim6Cynthia Villarreal-Garza7Department of Hemato-Oncology, Instituto Nacional de Ciencias Medicas y Nutricion Salvador ZubiranDepartment of Medicine, Yale University School of MedicineBreast Cancer Center, Hospital Zambrano Hellion, Tecnologico de MonterreyBreast Cancer Center, Hospital Zambrano Hellion, Tecnologico de MonterreyBreast Cancer Center, Hospital Zambrano Hellion, Tecnologico de MonterreyBreast Cancer Center, Hospital Zambrano Hellion, Tecnologico de MonterreyBreast Cancer Center, Hospital Zambrano Hellion, Tecnologico de MonterreyBreast Cancer Center, Hospital Zambrano Hellion, Tecnologico de MonterreyAbstract Background The use of taxanes following the first trimester of pregnancy is endorsed by current clinical guidelines. However, evidence regarding their safety in terms of obstetric and neonatal outcomes is limited. Methods A comprehensive literature search was performed using the MEDLINE, CENTRAL and Web of Sciences databases from their inception up to 12/16/2022. Eligibility criteria included gestational taxane use, presentation of original findings, and individual case data presented. A descriptive statistical analysis was undertaken. Results A total of 159 patients treated with taxane-containing regimens during pregnancy were identified, resulting in 162 fetuses exposed in utero. The majority of patients had breast cancer (n = 88; 55.3%) or cervical cancer (n = 45; 28.3%). The most commonly employed taxane was paclitaxel (n = 131; 82.4%). A total of 111 (69.8%) patients were also treated with other cytotoxic drugs during pregnancy, including platinum salts (n = 70; 63.0%) and doxorubicin/cyclophosphamide (n = 20; 18.0%). While most patients received taxanes during the second trimester of pregnancy (n = 79; 70.0%), two were exposed to taxanes in the first trimester. Obstetric outcomes were reported in 105 (66.0%) cases, with the most frequent adverse events being preterm contractions or premature rupture of membranes (n = 12; 11.4%), pre-eclampsia/HELLP syndrome (n = 6; 5.7%), and oligohydramnios/anhydramnios (n = 6; 5.7%). All cases with pregnancy outcome available resulted in live births (n = 132). Overall, 72 (54.5%) neonates were delivered preterm, 40 (30.3%) were classified as small for gestational age (SGA), and 2 (1.5%) had an Apgar score of < 7 at 5 min. Perinatal complications included acute respiratory distress syndrome (n = 14; 10.6%), hyperbilirubinemia (n = 5; 3.8%), and hypoglycemia (n = 2; 1.5%). In addition, 7 (5.3%) cases of congenital malformations were reported. At a median follow-up of 16 months, offspring health status was available for 86 (65.2%), of which 13 (15.1%) had a documented complication, including delayed speech development, recurrent otitis media, and acute myeloid leukemia. Conclusions Taxanes appear to be safe following the first trimester of pregnancy, with obstetric and fetal outcomes being similar to those observed in the general obstetric population. Future studies should aim to determine the most effective taxane regimen and dosage for use during gestation, with a specific focus on treatment safety.https://doi.org/10.1186/s12885-023-11704-6CancerPregnancyChemotherapyTaxanesNeonatal outcomesObstetric outcomes |
| spellingShingle | Alejandro Aranda-Gutierrez Ana S. Ferrigno Guajardo Bryan F. Vaca-Cartagena David G. Gonzalez-Sanchez Arantxa Ramirez-Cisneros Andrea Becerril-Gaitan Hatem A. Azim Cynthia Villarreal-Garza Obstetric and neonatal outcomes following taxane use during pregnancy: a systematic review BMC Cancer Cancer Pregnancy Chemotherapy Taxanes Neonatal outcomes Obstetric outcomes |
| title | Obstetric and neonatal outcomes following taxane use during pregnancy: a systematic review |
| title_full | Obstetric and neonatal outcomes following taxane use during pregnancy: a systematic review |
| title_fullStr | Obstetric and neonatal outcomes following taxane use during pregnancy: a systematic review |
| title_full_unstemmed | Obstetric and neonatal outcomes following taxane use during pregnancy: a systematic review |
| title_short | Obstetric and neonatal outcomes following taxane use during pregnancy: a systematic review |
| title_sort | obstetric and neonatal outcomes following taxane use during pregnancy a systematic review |
| topic | Cancer Pregnancy Chemotherapy Taxanes Neonatal outcomes Obstetric outcomes |
| url | https://doi.org/10.1186/s12885-023-11704-6 |
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