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The Cancer in Pregnancy ForumArchived Questions and Answers
This Forum has been the centre of an exceptional exchange of knowledge diagnosis, treatment, symptoms and other effects of cancer during pregnancy and lactation. All are welcome to review the Questions and Answers posted here, provided that they acknowledge and accept the important proviso and disclaimer below.
Dosing of antineoplastic drugs during pregnancy:
Several reviews exist in which possible changes in the pharmacokinetics of antineoplastic agents are described (Volume of distribution, Clearance, amniotic fluid as a "third space" etc.). Are there any recommendations or dose-modifications for antineoplastics during pregnancy with respect to the above mentioned pharmacokinetic changes? Is the current body-weight or the weight before pregnancy used for calculation of body-surface ?
Pregnancy is indeed associated with various pharmacokinetic changes. Even with regard to non-cancer conditions, very few drugs have been formally compared in pregnancy vs. postpartum. Presently we are not aware of any such studies with cancer chemotherapy in pregnancy. Consequently, there are no changes in dose guidelines for pregnancy. One may hypothesize that for most agents, either renally or hepatically eliminated, levels in pregnancy will be lower and potentially, effect may decrease.