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Table 1 Patients and tumours’ characteristics, treatments and outcomes

From: Use of trastuzumab in treating breast cancer during pregnancy: a systematic review and meta-analysis

Characteristic Goodyer et al. [7] Waterston et al. [1] Azim Jr et al. [8] Min et al. [9] Pant et al. [10]
Stage IV NR IIB NR IV
Treatment Trastuzumab Trastuzumab Trastuzumab Trastuzumab Trastuzumab
Receptor (ER\PR\HER-2) (−)(−)(+) (−)(−)(+) (−)(−)(+) (−)(−)(+) (−)(−)(+)
Age at pregnancy (y) 33 30 29 32 32
GA (week) 14 3 3 17 14
Trastuzumab
 Schedule (weeks) 1 3 3 3 3
 Total dose NR 1259 mg NR 600 mg 4200 mg
 GA (week) 14–29 0–3 0–1 0–17 0–32
 Chemotherapy No No No No No
 Pregnancy/fetal complication No No No No Anhydramnios
Delivery
 Weeks 29 NR 39 38 + 5 32 + 1
 Mode cs Vaginal cs Vaginal Vaginal
New born
 Weight (g) 1220 NR 3550 3570 1810
 Apgar scores NR NR NR 9, 10 normal
 Complications Respiratory distress syndrome No No No No
 Follow-up (months) Minimal tightness of the left Achilles tendon at 36 months NR Healthy at 14 months NR healthy at 60 months
Characteristic Pianca et al. [11] Rasenack et al. [12] Bader et al. [13] Mandrawa et al. [14] Roberts et al. [15]
Stage IIA IV IV IV IIB
Treatment Trastuzumab Trastuzumab 46 Gy (cervical vertebra) with shielding + trastuzumab + paclitaxel Trastuzumab Trastuzumab
Receptor (ER\PR\HER-2) (−)(−)(+) (−)(−)(+) (−)(+)(+) (−)(−)(+) (−)(−)(+)
Age at pregnancy (y) 30 29 38 28 36
GA (week) 28 NR 17 12 17
Trastuzumab
 Schedule (weeks) 3 3 3 3 3
 Total dose NR NR NR 3510 mg NR
 GA (week) 0–28 0–24 25–28 0–27 4–21
 Chemotherapy No No Paclitaxel (25 week) No No
 Pregnancy/fetal complication Anhydramnios Anhydramnios Anhydramnios, fetal renal failure Anhydramnios Decline of cardiac ejection fraction
Delivery
 Weeks 37 36 32 37 37
 Mode Vaginal CS CS Vaginal Vaginal
New born
 Weight (g) 2535 NR 1460 3060 3200
 Apgar scores 4, 8 NR NR NR NR
 Complications No No Signs of bacterial sepsis (hypotension, transient renal failure, respiratory failure, positive laboratory findings Transient tachypnoea at birth Mild transient tachypnoea
 Follow-up (months) Healthy at 84 months Healthy at 60 months Healthy at 3 months Healthy at 28 months NR
Characteristic Witzel et al. [16] Shrim et al. [17] Beale et al. [18] Warraich et al. [19]
Stage IV IV NR NR
Treatment Trastuzumab Trastuzumab Trastuzumab + tamoxifen Trastuzumab + tamoxifen + goserelin
Receptor (ER\PR\HER-2) (+)(+)(+) (−)(−)(+) (+)(+)(+) (+)(+)(+)
Age at pregnancy (y) 34 32 29 35
GA
(week) 23 5 23 7
Trastuzumab
 Schedule (weeks) 3 3 3 3
 Total dose NR 3200 mg NR 3675 mg
 GA (week) 0–26 0–24 0–22 7–31
 Chemotherapy No No No No
 Pregnancy/fetal complication Oligohydramnios and vaginal bleeding Asymptomatic low ejection fraction (weeks 18, 24) Anhydramnios Anhydramnios
Delivery
 Weeks 27 37 31 34
 Mode CS CS CS NR
New born
 Weight (g) 1015 2600 1590 and 1705 NR
 Apgar scores 8, 7 9, 10 5, 8 and 8, 10 NR
 Complications Respiratory failure, strong capillary link syndrome, persisting infections, necrotizing enterocolitis Transient tachypnea at birth Twin A: chronic lung disease and renal failure, Twin B: creatinine elevation and respiratory distress syndrome at birth Severe pulmonary hypoplasia and atelectasis
 Follow-up (months) Dead at 5.25 months Healthy at 2 months Twin A:Dead from respiratory arrest at 0.25 months, TwinB:Healthy at 0.25 months Dead within 40 min at birth
Characteristic Watson et al. [20] Fanale et al. [21] Sekar et al. [22] Weber et al. [23]
Stage IIIB IV IV IV
Treatment Trastuzumab Vinorelbine + trastuzumab Docetaxel + trastuzumab Trastuzumab
Receptor (ER\PR\HER-2) (−)(−)(+) (−)(−)(+) (−)(−)(+) NR
Age at pregnancy (y) 28 27 28 32
GA (week) 23 27 20 NR
Trastuzumab
 Schedule (weeks) 3 1 3 3
 Total dose 3480 mg 2700 mg 1385 mg NR
 GA (week) 0–20 27–34 23–27 0–23
 Chemotherapy No Vinorelbine (at 27 week) Docetaxel (at 23 week) No
 Pregnancy/fetal complication Anhydramnios and small fetal bladder (23 weeks) Anhydramnios Anhydramnios Anhydramnios
Delivery
 Weeks 37 34 36 27
 Mode Vaginal Vaginal CS CS
New born
 Weight (g) 2960 2580 2230 NR
 Apgar scores 8, 9 9, 9 7, 9 NR
 Complications No No No Multiple prematurity related problems at birth
 Follow-up (months) Healthy at 6 months Healthy at 6 months NR Dead at 4 months
Characteristic Gottschalk et al. [24] El-Safadi et al. [25] Andrade et al. [26] Aktoz et al. [27]
Stage NR IV III IV
Treatment Docetaxel + carboplatin + trastuzumab Vinorelbine + trastuzumab + ibandronate Trastuzumab Docetaxel + trastuzumab
Receptor (ER\PR\HER-2) (+)(+)(+) (−)(−)(+) NR (−)(−)(+)
Age at pregnancy (y) 38 32 31 37
GA (week) 11 29 9 22
Trastuzumab
 Schedule (weeks) 1 3 3 3
 Total dose NR NR 4400 mg 2293 mg
 GA (week) 14–17 30–33 0–32 22–34
 Chemotherapy Docetaxel + carboplatin (at 17 week) Vinorelbine + ibandronate (at 30 week) No Docetaxel (at 22 week)
 Pregnancy/fetal complication Anhydramnios, intrauterine growth restriction, fetal renal insufficiency Anhydramnios Anhydramnios No
Delivery
 Weeks 33 33 32+2 35+3
 Mode CS CS CS CS
New born
 Weight (g) NR 1990 1655 2850
 Apgar scores NR 8, 9 4, 10 8, 8
 Complications Dystrophic premature neonate at birth No Respiratory distress syndrome and a pulmonary infection Transient renal insufficiency
 Follow-up (months) NR Healthy at 12 months Healthy at 84 months Healthy at 5 days
  1. GA gestational age, NR not reported, CS cesarean section