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Article

Evolution of Angiogenic Factors in Pregnant Patients with Breast Cancer Treated with Chemotherapy

1
Medical Oncology Department, Vall d’Hebron University Hospital, Vall d’Hebrón Institute of Oncology (VHIO), 08035 Barcelona, Spain
2
Maternal and Child Health and Development Network (SAMID), RD12/0026/16 and RD16/0022/0015, Institute of Health Carlos III, 28029 Madrid, Spain
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Biochemistry and Molecular Biology Research Centre for Nanomedicine, Vall d’Hebron Research Institute, 08035 Barcelona, Spain
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Vall d’Hebrón Institute of Oncology (VHIO), 08035 Barcelona, Spain
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Center for Biomedical Research on Rare Diseases (CIBERER), 08028 Barcelona, Spain
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Oncology Data Science (ODysSey), Vall d’Hebrón Institute of Oncology (VHIO), 08028 Barcelona, Spain
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Pediatrics Department, Vall d’Hebron University Hospital, 08035 Barcelona, Spain
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Vall d’Hebrón Institute of Oncology (VHIO), International Breast Cancer Center, Quiron Group, 08035 Barcelona, Spain
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Department of Obstetrics, Maternal-Fetal Medicine Unit, Santa Creu i Sant Pau University Hospital, Universitat Autònoma de Barcelona, 08025 Barcelona, Spain
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Obstetrics and Gynecology Department, Hospital Universitari Son Espases, 07120 Palma, Spain
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Institut d’Investigació Sanitària de les Illes Balears (IdISBa), 07120 Palma, Spain
*
Author to whom correspondence should be addressed.
Authors contributed equally.
Academic Editor: Matteo Lambertini
Cancers 2021, 13(4), 923; https://doi.org/10.3390/cancers13040923
Received: 22 January 2021 / Revised: 14 February 2021 / Accepted: 19 February 2021 / Published: 23 February 2021
(This article belongs to the Special Issue Cancer and Pregnancy)
Anthracyclines and taxanes are being used as a standard treatment for breast cancer diagnosed during pregnancy. These chemotherapy regimens allow the continuation of pregnancy without delaying cancer treatment with relatively good maternal and neonatal outcomes. However, their effects on placental function and fetal development are not completely understood. Maternal serum angiogenic factors are a surrogate of placental function and are abnormal weeks before placental complications such as preeclampsia or intrauterine growth restriction development. In our cohort, pregnant women with breast cancer treated with chemotherapy during pregnancy show an antiangiogenic state with significantly higher levels of soluble fms-like tyrosine kinase (sFlt-1), sFlt-1/PGF ratio, and soluble endoglin (sEng) at the end of the third trimester. Angiogenic factors could be useful in the clinical obstetric management of these patients, although more studies are guaranteed.
High prevalence of placental-derived complications, such as preeclampsia and intrauterine growth restriction, has been reported in women with breast cancer (BC) treated with chemotherapy during pregnancy (PBC-CHT). Aim: To ascertain whether PBC-CHT is associated with an imbalance of angiogenic factors, surrogate markers for placental insufficiency, that could explain perinatal outcomes. Methods: Prospective study between 2012 and 2016 in a single institution. Soluble fms-like tyrosine kinase (sFlt-1), placental growth factor (PlGF), and soluble endoglin (sEng) in maternal blood were assessed throughout pregnancy in 12 women with BC and 215 controls. Results: Cancer patients were treated with doxorubicin-based regimes and with taxanes. Ten PBC-CHT (83%) developed obstetrical complications. At the end of the third trimester, significantly higher levels of sFlt-1; sFlt-1/PGF ratio, and sEng levels were observed in BC women as compared to controls. Moreover; there was a significant correlation between plasma levels of sFlt-1 and the number of chemotherapy cycles administered. Besides, more chemotherapy cycles correlated with lower birthweight and head circumference at birth. Conclusions: Women with BC treated during pregnancy showed an antiangiogenic state compatible with placental insufficiency. Angiogenic factors could be useful in the clinical obstetric management of these patients; although further studies will be required to guide clinical decision-making. View Full-Text
Keywords: breast cancer; pregnancy; angiogenic factors; chemotherapy breast cancer; pregnancy; angiogenic factors; chemotherapy
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MDPI and ACS Style

Saura, C.; Sánchez, O.; Martínez, S.; Domínguez, C.; Dienstmann, R.; Ruíz-Pace, F.; Céspedes, M.C.; Peñuelas, Á.; Cortés, J.; Llurba, E.; Córdoba, O. Evolution of Angiogenic Factors in Pregnant Patients with Breast Cancer Treated with Chemotherapy. Cancers 2021, 13, 923. https://doi.org/10.3390/cancers13040923

AMA Style

Saura C, Sánchez O, Martínez S, Domínguez C, Dienstmann R, Ruíz-Pace F, Céspedes MC, Peñuelas Á, Cortés J, Llurba E, Córdoba O. Evolution of Angiogenic Factors in Pregnant Patients with Breast Cancer Treated with Chemotherapy. Cancers. 2021; 13(4):923. https://doi.org/10.3390/cancers13040923

Chicago/Turabian Style

Saura, Cristina, Olga Sánchez, Sandra Martínez, Carmen Domínguez, Rodrigo Dienstmann, Fiorella Ruíz-Pace, Maria C. Céspedes, Ángeles Peñuelas, Javier Cortés, Elisa Llurba, and Octavi Córdoba. 2021. "Evolution of Angiogenic Factors in Pregnant Patients with Breast Cancer Treated with Chemotherapy" Cancers 13, no. 4: 923. https://doi.org/10.3390/cancers13040923

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