Common chemo agent safe for pregnant women and babies

World first research announced in Australia on Nov 16 shows that the most common form of chemotherapy is safe for use in pregnant women with cancer, putting to rest decades of conjecture and likely to result in changes to treatment guidelines.

The UT MD Anderson Cancer Center in Houston, has new data showing that pregnant women who have cancer can safely tolerate standard doses of carboplatin, the most commonly used chemotherapy, resolving the long debated issue about whether the drug has toxic effects on the foetus.

Doctor Judith Smith, from The UT MD Anderson Cancer Center’s Department of Gynaecologic Oncology and Reproductive Medicine, will unveiled her findings at the Clinical Oncological of Australia’s Annual Scientific Meeting in Perth.

“We have been able to show that in using carboplatin for women who are pregnant, only a minimal amount is able to cross the placenta barrier,” Prof Smith said. “These levels are not toxic and contrary to orthodox opinion, unborn babies are not at risk.”

Dr Smith said up to 1 in 1000 of pregnancies were to women who had cancer, which was often diagnosed during the pregnancy. “More often than not, these women decide not to have chemotherapy during pregnancy or to delay their treatment, with potentially poorer outcomes.

“There are also instances where women are informed they have cancer in the first trimester, sometimes resulting in heart-wrenching decisions to abort.”

According to Dr Smith, the findings will improve choices and outcomes for pregnant women with cancer. Research is underway to assess the effects of other forms of chemotherapy. Concurrent research into antiemetics used to reduce vomiting and nausea (with the drug granisetron) have also been found safe, with no amount of the drug crossing the placenta.

Clinical Oncological Society of Australia President and practising oncologist, Professor Bogda Koczwara, said the announcement was welcome news for pregnant women and was expected to result in changes to treatment recommendations.

“The distress and anxiety of a cancer diagnosis for a woman who is pregnant is made far worse if she is told chemotherapy might be toxic for her baby,” Professor Koczwara said. “Now we can reassure women that at least the most common form of chemotherapy is safe in pregnancy and that treating their cancer will not be harmful to their unborn child.

“This will also come as a relief for oncologists who often agonise over whether their recommendation of chemotherapy might have resulted in harm to the foetus.”

(Source: Clinical Oncological Society of Australia)

More information

For more information on cancer, including breast, prostate, kidney and stomach cancer, see Cancer: Overview.

For more information about pregnancy, including preconception advice, stages of pregnancy, investigations, complications, living with pregnancy and birth, see Pregnancy.