Περίληψη:
Background: Immune checkpoint inhibitors have been widely implemented in
current clinical practice. Although cancer occurs in similar to 1 out of
1000 pregnancies, treatment remains challenging. Until now, limited data
exist regarding immunotherapy administration during pregnancy. This
systemic review aims to synthesize all available data from immunotherapy
administration in pregnant women and evaluate the efficacy and safety of
immunotherapy during pregnancy.
Patients and methods: Eligible studies were identified by a search of
the PubMed Medline database and Food and Drug Administration Adverse
Events Reporting System Public Dashboard for the period 1 January 2000
to 1 April 2021; the algorithm consisted of a predefined combination of
the words ‘immunotherapy’, ‘cancer’ and ‘pregnancy’. PRISMA guidelines
were applied in this study.
Results: Overall, seven articles (seven pregnancies, nine neonates) were
retrieved. The mean duration of immunotherapy administration was 9.8
weeks [standard deviation (SD): 11.27; median: 7.0; range: 1-32]. In
all cases specified, melanoma was the malignancy reported. The mean
gestational age at delivery was 30.4 weeks (SD: 5.03; median: 32.0;
range: 24-38), whereas the mean weight of neonates at delivery was 1267
g (SD: 412.0; median: 1400; range: 590-1701). Only one neonate was born
term at 38 weeks of pregnancy (11.1%; 1/9). Complications during
pregnancy were observed in 71.4% of cases: intrauterine growth
restriction (three cases), HELLP syndrome (hemolysis, elevated liver
enzymes, low platelet count) (one case), placental insufficiency (one
case) and low fetal heart rate (one case). The mean progression-free
survival and overall survival were 16.0 and 25.2 months, respectively.
Conclusion: The administration of immune checkpoint inhibitors during
pregnancy is associated with increased incidence of pregnancy
complications, prematurity and low birth weight. The administration of
these regimens is not recommended during gestation. Whenever applied,
close monitoring of the mother and the fetus is required.
Συγγραφείς:
Andrikopoulou, A.
Korakiti, A. M.
Apostolidou, K. and
Dimopoulos, M. A.
Zagouri, F.
