Doxorubicin and ifosfamide for high-grade sarcoma during pregnancy
Open Access
- 19 July 2011
- journal article
- clinical trial
- Published by Springer Science and Business Media LLC in Cancer Chemotherapy and Pharmacology
- Vol. 69 (2), 357-367
- https://doi.org/10.1007/s00280-011-1707-8
Abstract
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.Keywords
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