Abstract PS13-03: Safety of taxane chemotherapy for the treatment of breast cancer during pregnancy: an international cohort study

Abstract

Abstract Introduction: The addition of taxanes to anthracycline-based chemotherapy regimens offers increased odds of survival in breast cancer (BC) patients. However, some clinicians defer their use in pregnant patients due to limited evidence supporting safety during gestation. The aim of this study is to describe the prevalence of maternal and neonatal adverse events in BC patients exposed to taxane-containing regimens during pregnancy. Methods: This is an international cohort study of BC patients treated with taxane chemotherapy during pregnancy. Inclusion criteria were age ≥18 years, treatment in a participating center (n=10), and completion of pregnancy. Results: A total of 103 women with a median age of 34 years (range 21-44) were included, of whom the majority (91/101; 90.1%) were also exposed to anthracyclines. The median gestational age at initiation of any chemotherapy agent was 16 weeks (range 4-34), while that of taxanes was 28 weeks (range 12-37). Paclitaxel was the most frequently used taxane (100/103; 97.1%), most prescribed as an 80 mg/m2 weekly infusion. All cases were singleton pregnancies except for one twin gestation. The overall live birth rate was 98.0% (100/102). Median gestational age at delivery was 37 weeks (range 32 to 40), with 36/83 live births being preterm (gestational age of < 37 weeks; 43.4%). Median birth weight was 2700 grams (range 1440-4000). The prevalence of grade 3 to 4 adverse events, obstetric complications, and neonatal outcomes are shown in the Table. A total of 56/58 (96.6%) of neonates had a 5-minute Apgar score ≥7 and 14/88 (15.9%) were admitted to a neonatal intensive care unit. Follow-up beyond the neonatal period was available for 28 neonates (median 42 months, range 1-228), of which reported adverse events were: cardiac abnormality (n=1), speech disorder (n=1), renal disfunction (n=1), and femoral anteversion (n=1). Conclusion: The use of taxane-containing chemotherapy during pregnancy does not seem to increase the risk of obstetric and neonatal complications. Our findings support the use of taxanes during gestation when clinically indicated. Table 1. Reported adverse events with gestational use of taxane-containing chemotherapy regimens. Citation Format: Ana Ferrigno Guajardo, Bryan Vaca-Cartagena, Erica Mayer, Chayma Bousrih, Oluchi Oke, Cristina Saura, Fedro Alessandro Peccatori, Wendy Muñoz-Montaño, Alvaro Cabrera-Garcia, Matteo Lambertini, Luis Corrales, Andrea Becerril-Gaitan, Tal Sella, Alexandra Newman, Barbara Pistilli, Ashley Martinez, Carolina Ortiz, Laia Joval-Ramentol, Giovanna Scarfone, Barbara Buonomo, Fernando Lara-Medina, Jacqueline Sanchez, Luca Arecco, Allan Ramos-Esquivel, Snezana Susnjar, Gilberto Morgan, Cynthia Villarreal-Garza, Hatem Azim. Safety of taxane chemotherapy for the treatment of breast cancer during pregnancy: an international cohort study [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PS13-03.