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The Cancer in Pregnancy Forum

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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.
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Forum > Cancer - Active Topics: Cancer - Active Topics
Chemotherapy Dosing During Pregnancy

CCoPE
Date: 2008-04-30

Question:
Chemotherapy dosing during pregnancy Are there any guidelines for chemotherapy dose modifications during pregnancy based on the increasing maternal body weight, or would the initial body weight be used for the BSA calculation throughout the pregnancy? If the dose is adjusted, would this be done prior to each cycle? I look forward to hearing your opinion. Kind regards, Sabine Kaestner MPharmSci, PhD (UK)

Answer:
Pregnancy, in addition to increased body weight, is associated with increased metabolism due to heightened activity of several cytochrome enzymes, including CYP3A4 and CYP2A6. Presently, no study has evaluated pharmacokinetic changes of chemotherapeutic agents during pregnancy and no guidelines for dose adjustment exist.

Because most of the changes in body weight occur late in pregnancy, it is conceivable to consider changes in dose if there is evidence of decreased pharmacological response to the drug. This must be done case-by-case by the team, considering efficacy, toxicity and fetal well-being.

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