June 18, 2024

New Study Reveals Risks of Anti-ERBB2 Cancer Drugs During Pregnancy

A recent study published in JAMA Network Open has shed light on the potential risks associated with using anti-ERBB2 inhibitors, such as trastuzumab, pertuzumab, and c, during pregnancy. These drugs are commonly used to treat breast tumors that are ERBB2-positive and hormone receptor-negative. While the treatment of breast cancer typically remains the same during pregnancy, the health of the fetus must be carefully considered when deciding on the choice of therapy.

The study utilized the World Health Organization (WHO) VigiBase, a database that collects information on adverse drug reactions from case reports worldwide. Researchers analyzed over 3,500 cases of cancer complicating pregnancy and categorized the patients into anti-ERBB2 recipients and those who received other drugs. The study aimed to determine the likelihood of maternal or fetal complications with ERBB2 antagonists compared to other antineoplastic agents.

The findings of the study revealed that the use of anti-ERBB2 agents during pregnancy is associated with specific and significant adverse outcomes for both the pregnancy and the fetus. Oligohydramnios, a condition characterized by low levels of amniotic fluid, was reported in approximately 25% of exposures to anti-ERBB2 drugs. Preterm birth and intrauterine growth restriction (IUGR) were also observed in a significant number of cases.

Furthermore, the study revealed that fetuses exposed to trastuzumab-emtansine were at a five-fold increased risk of cardiovascular defects, while those exposed to lapatinib were at an eight-fold increased risk of IUGR.

These findings highlight the importance of careful consideration when using anti-ERBB2 agents during pregnancy, due to the potential harm they may cause to the fetus. Currently, trastuzumab is contraindicated in pregnancy due to the high risk of oligohydramnios and anhydramnios. However, there is a lack of data on the safety of other anti-ERBB2 agents during pregnancy, which necessitates further studies to confirm their toxicity.

If oligohydramnios is identified during anti-ERBB2 therapy, it is recommended to monitor the condition closely and consider withdrawing these agents, despite their efficacy in treating hormone receptor-negative breast cancers in pregnant women.

It is important to note that the data analyzed in this study came from multiple sources, and there may be variability in its quality. Therefore, additional studies are needed to validate these findings and provide more comprehensive insights into the risks associated with anti-ERBB2 inhibitors during pregnancy.

1. Source: Coherent Market Insights, Public sources, Desk research
2. We have leveraged AI tools to mine information and compile it