Experts have issued updated guidance on the management of pregnant women with gynaecological cancers. The guidelines have been developed by the International Network on Cancer, Infertility and Pregnancy (INCIP) and other experts, and reflect new insights and experience gained since the previous guidelines were published in 2014.
Key among the recommendations are:
- Non-ionising imaging procedures are the preferred diagnostic procedures, but limited ionising imaging methods can be allowed if essential for treatment plans.
- Most standard regimens of chemotherapy can be administered after 14 weeks' gestational age but are not recommended beyond 35 weeks.
- C-section is recommended for most cervical and vulvar cancers, whereas vaginal delivery is allowed in most ovarian cancers.
- Breastfeeding should be avoided with ongoing chemotherapeutic, endocrine or targeted treatment.
The guidelines recommend that more studies should be carried out on the long-term toxic effects of gynaecologic cancer treatments to provide a full understanding of their foetal impact. In particular, the experts say, data on targeted therapies are still limited.
It also encourages participation in existing registries and the creation of multidisciplinary national tumour boards drawn where they do not already exist.