Targeted therapy for breast cancer during pregnancy

In large part because of the general age increase among pregnant women, the number of pregnant breast cancer patients has risen. Specific goal-oriented treatment methods for nonpregnant patients have led to significant results; for example, trastuzumab can vastly improve the prognosis of patients with HER2-positive receptor status. But for pregnant patients, there has so far been very little anecdotal evidence of applied therapies that have not exhibited an obstruction to the pregnancy. The most commonly observed side effect of trastuzumab is oligohydramnios or anhydramnios. In a case report involving lapatinib, a tyrosine kinase inhibitor, the pregnancy was uneventful, and a healthy child was born. Antiangiogenetic therapy during pregnancy is strongly contraindicated; this was made known through the use of thalidomide (Contergan). Nevertheless, bevacizumab was locally applied to a pregnant patient's eye. No side effects or harmful after-effects have been reported for this form of therapy. All patients with breast cancer during pregnancy should be recorded in the German Breast Group's study register in order to accurately assemble current case report data and thereby help enable thorough consultations for future pregnant breast cancer patients. © 2009 Springer Medizin Verlag.