Study finds that anti-ERBB2 inhibitors used in breast cancer treatment pose significant risks to pregnancy and fetal health, including higher likelihoods of congenital defects and intrauterine growth restriction.
By Dr. Liji Thomas, MDOct 29 2023Reviewed by Benedette Cuffari, M.Sc. While the treatment of breast cancer does not change with pregnancy status unless absolutely necessary, the health of the fetus must be carefully considered while deciding on the choice of therapy.
Nevertheless, breast tumors that are ERBB2-positive and hormone receptor-negative are primarily treated with anti-ERBB2 agents as a result of their historical efficacy. Since the use of these agents in pregnancy is dependent on the expectation of greater maternal benefit as compared to fetal harm, extensive studies are required to confirm their safety during pregnancy.
The mean participant age in the anti-ERBB2 group was about 31 years, with nearly half of patients from the United States. Most were being treated for breast cancer. The most commonly used drug was trastuzumab, with about 20 each receiving trastuzumab-emtansine or lapatinib, while 55 were on pertuzumab.
Oligohydramnios were reported in about 25% of exposures, whereas preterm birth was reported in over one in seven cases. Intrauterine growth restriction was reported in 10% of cases. Fetal kidney failure, leading to oligohydramnios, and subsequently to pulmonary hypoplasia and neonatal respiratory disorders, has been described in a Potter sequence.”
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