Supportive medication in cancer during pregnancy
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(2020) 20:747
REVIEW
Open Access
Supportive medication in cancer during pregnancy Flora Zagouri*, Nikolaos Dedes, Alkistis Papatheodoridi, Michael Liontos and Meletios Athanasios Dimopoulos
Abstract While pregnancy-related malignancies are quite rare, their incidence is increasing and thus affecting more and more women nowadays. Their management, however, with both chemotherapy and supportive agents remains quite challenging and it seems crucial to define the optimal treatment for this special population. Concerning supportive medication, it is clinically significant to determine whether commonly used agents, including Granulocyte Colony-Stimulating Factors, Erythropoiesis-stimulating agents, Bisphosphonates, Anticoagulation agents, Antiemetics and Glucocorticoids are indeed effective in ameliorating chemotherapy side effects. Meanwhile, it is of great importance that the administration of any of these agents is safe for both mother and fetus. This review aims to provide a précis of the current literature regarding both safety and efficacy of all categories of supportive medication during pregnancy. Keywords: Ooncology patients, Pregnancy supportive care, Ggranulocyte colony-stimulating factors, Erythropoiesisstimulating agents, bisphosphonates, Aanticoagulation agents, Antiemetics, Glucocorticoids
Introduction Pregnancy complicated by cancer is considered a rare phenomenon, however, mostly due to modern lifestyle, it is becoming ever more frequent and the challenge of managing such cases, ever more daunting[1–4]. The malignancies affecting pregnant women do not differ from those affecting age-matched non-pregnant women and are -in order of decreasing incidence- melanoma, breast cancer, cervical cancer, lymphomas and leukemias [4]. Unfortunately though, it is not easy to obtain a reliable epidemiologic profile of this situation as obstetrical and oncological registries are not uniform internationally and data concerning miscarriages and voluntary or therapeutic abortions are often missing [2]. One further limitation is that findings across studies are difficult to be interpreted and compared, as outcomes can be referring to either pregnancies or live births [2]. Nonetheless, * Correspondence: [email protected] Haematology - Oncology Unit, Department of Clinical Therapeutics, Alexandra Hospital, National and Kapodistrian University of Athens, Vasilissis Sofias 80, 11528 Athens, Greece
cancer during pregnancy is believed to occur once per 1, 000 pregnancies annually [4]. Regardless of the epidemiologic figures, what is the sole concern of the pregnant patient, is treatment and its possible fallout. Such therapeutic challenges call for an interdisciplinary approach in order for the most suitable strategy to be developed. In this spirit, the aspiration of this review is to revisit supportive treatment options and to investigate individual agents as to their efficacy in alleviating chemotherapy side effects, while highlighting any associated risks of their administration for either mother or fetus. Granuloc
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