Introduction The addition of taxanes to anthracycline-based chemotherapy is considered standard of care in the treatment of breast cancer. However, there are insufficient data regarding the safety of taxanes during pregnancy. The aim of this study was to describe the incidence of obstetric and neonatal adverse events associated with the use of taxane-containing chemotherapy regimens for the treatment of breast cancer during pregnancy. Methods This is a multicenter, international cohort study of breast cancer patients treated with taxanes during pregnancy. A descriptive analysis was undertaken to synthetize available data. Results A total of 103 patients were included, most of whom were treated with paclitaxel and anthracyclines given in sequence during gestation (90.1%). The median gestational age at taxane initiation was 28 weeks (range = 12-37 weeks). Grade 3-4 adverse events were reported in 7 of 103 (6.8%) patients. The most common reported obstetric complications were intrauterine growth restriction (n = 8 of 94, 8.5%) and preterm premature rupture of membranes (n = 5 of 94, 5.3%). The live birth rate was 92 of 94 (97.9%), and the median gestational age at delivery was 37 weeks (range = 32-40 weeks). Admission to an intensive care unit was reported in 14 of 88 (15.9%) neonates, and 17 of 70 (24.3%) live births resulted in small for gestational age neonates. Congenital malformations were reported in 2 of 93 (2.2%). Conclusion Obstetric and neonatal outcomes after taxane exposure during pregnancy were generally favorable and did not seem to differ from those reported in the literature with standard anthracycline-based regimens. This study supports the use of taxanes during gestation when clinically indicated.

中文翻译：

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紫杉烷类药物治疗妊娠期乳腺癌：一项国际队列研究

简介 在以蒽环类药物为基础的化疗中添加紫杉烷类药物被认为是乳腺癌治疗的标准护理方法。然而，关于怀孕期间紫杉烷类药物安全性的数据不足。本研究的目的是描述与妊娠期间使用含紫杉烷化疗方案治疗乳腺癌相关的产科和新生儿不良事件的发生率。方法 这是一项针对妊娠期间接受紫杉烷类药物治疗的乳腺癌患者的多中心、国际队列研究。进行了描述性分析以综合可用数据。结果共纳入103例患者，其中大多数患者在妊娠期间先后接受了紫杉醇和蒽环类药物治疗（90.1%）。开始使用紫杉烷时的中位孕龄为 28 周（范围 = 12-37 周）。103 名患者中有 7 名 (6.8%) 报告了 3-4 级不良事件。最常见的产科并发症是宫内生长受限（n = 94 例中的 8 例，8.5%）和早产胎膜早破（n = 94 例中的 5 例，5.3%）。活产率为 94 例中的 92 例 (97.9%)，分娩时的中位孕周为 37 周（范围 = 32-40 周）。据报道，88 名新生儿中有 14 名（15.9%）被送入重症监护室，70 名活产中有 17 名（24.3%）为小于胎龄新生儿。93 例中有 2 例（2.2%）报告有先天性畸形。结论 妊娠期间接触紫杉烷后的产科和新生儿结局总体良好，似乎与文献中报道的基于标准蒽环类药物的治疗方案没有差异。这项研究支持在有临床指征时在妊娠期间使用紫杉烷类药物。