Management of Cancer During Pregnancy: ASCO Guideline

Area of Science:

• Oncology
• Maternal-Fetal Medicine
• Evidence-Based Medicine

Background:

• Managing cancer in pregnant patients presents unique challenges for maternal and fetal well-being.
• Requires careful consideration of diagnostic and therapeutic interventions.
• Existing evidence often comprises observational data and case reports.

Purpose of the Study:

• To establish evidence-based guidelines for the management of cancer in pregnant individuals.
• Provide recommendations for diagnostic evaluation and treatment strategies.
• Ensure optimal outcomes for both the mother and the developing fetus.

Main Methods:

• Systematic literature review conducted by a multidisciplinary Expert Panel.
• Analysis of 450 eligible studies, including observational data, case series, and case reports.
• Synthesis of evidence to inform clinical recommendations.

Main Results:

• Identified a significant body of literature, primarily observational, on cancer in pregnancy.
• Highlighted the need for individualized approaches to diagnosis and treatment.
• Detailed specific contraindications for certain systemic therapies.

Conclusions:

• Management should prioritize a values-based informed-consent process.
• Diagnostic imaging should adhere to the as low as reasonably achievable (ALARA) principle.
• Systemic therapy generally deferred to the second trimester; certain agents are contraindicated. Delivery timing and psychosocial support are crucial.