References

Amant, F., Han, S. N., Gziri, M. M., Dekrem, J., & Van Calsteren, K. (2012a). Chemotherapy during pregnancy. Current Opinion in Oncology, 24(5), 580–586. https://doi.org/10.1097/CCO.0b013e328354e754

Amant, F., Vandenbroucke, T., Verheecke, M., Fumagalli, M., Halaska, M. J., Boere, I., Han, S., Gziri, M. M., Peccatori, F., Rob, L., Lok, C., Witteveen, P., Voigt, J. U., Naulaers, G., Vallaeys, L., Van den Heuvel, F., Lagae, L., Mertens, L., Claes, L., Van Calsteren, K.,…International Network on Cancer, Infertility, and Pregnancy (INCIP). (2015). Pediatric outcome after maternal cancer diagnosed during pregnancy. The New England Journal of Medicine, 373(19), 1824–1834. https://doi.org/10.1056/NEJMoa1508913

Amant, F., Van Calsteren, K., Halaska, M. J., Gziri, M. M., Hui, W., Lagae, L., Willemsen, M. A., Kapusta, L., Van Calster, B., Wouters, H., Heyns, L., Han, S. N., Tomek, V., Mertens, L., & Ottevanger, P. B. (2012b). Long-term cognitive and cardiac outcomes after prenatal exposure to chemotherapy in children aged 18 months or older: An observational study. The Lancet Oncology, 13(3), 256–264. https://doi.org/10.1016/S1470-2045(11)70363-1

Amarjothi, J. M. V., Ramasamy, V., Senthil Kumaran, G. R., & Naganath Babu, O. L. (2019). Challenges associated with colorectal cancer in pregnancy. Case Reports in Gastroenterology, 13(2), 253–257. https://doi.org/10.1159/000500078

Avilés, A., & Neri, N. (2001). Hematological malignancies and pregnancy: A final report of 84 children who received chemotherapy in utero. Clinical Lymphoma, 2(3), 173–177. https://doi.org/10.3816/clm.2001.n.023

Boere, I., Lok, C., Vandenbroucke, T., & Amant, F. (2017). Cancer in pregnancy: Safety and efficacy of systemic therapies. Current Opinion in Oncology, 29(5), 328–334. https://doi.org/10.1097/CCO.0000000000000386

Burotto, M., Gormaz, J. G., Samtani, S., Valls, N., Silva, R., Rojas, C., Portiño, S., & de la Jara, C. (2018). Viable pregnancy in a patient with metastatic melanoma treated with double checkpoint immunotherapy. Seminars in Oncology, 45(3), 164–169. https://doi.org/10.1053/j.seminoncol.2018.03.003

Cao, S., Okekpe, C. C., Dombrovsky, I., Valenzuela, G. J., & Roloff, K. (2020). Colorectal cancer diagnosed during pregnancy with delayed treatment. Cureus, 12(5), e8261. https://doi.org/10.7759/cureus.8261

Cardonick, E. H., Gringlas, M. B., Hunter, K., & Greenspan, J. (2015). Development of children born to mothers with cancer during pregnancy: Comparing in utero chemotherapy-exposed children with nonexposed controls. American Journal of Obstetrics and Gynecology, 212(5), 658.e1–658.e6588. https://doi.org/10.1016/j.ajog.2014.11.032

Cardonick, E., & Iacobucci, A. (2004). Use of chemotherapy during human pregnancy. The Lancet Oncology, 5(5), 283–291. https://doi.org/10.1016/S1470-2045(04)01466-4

Cardonick, E., Usmani, A., & Ghaffar, S. (2010). Perinatal outcomes of a pregnancy complicated by cancer, including neonatal follow-up after in utero exposure to chemotherapy: Results of an international registry. American Journal of Clinical Oncology, 33(3), 221–228. https://doi.org/10.1097/COC.0b013e3181a44ca9

Chakravarty, D., Johnson, A., Sklar, J., Lindeman, N. I., Moore, K., Ganesan, S., Lovly, C. M., Perlmutter, J., Gray, S. W., Hwang, J., Lieu, C., André, F., Azad, N., Borad, M., Tafe, L., Messersmith, H., Robson, M., & Meric-Bernstam, F. (2022). Somatic genomic testing in patients with metastatic or advanced cancer: ASCO provisional clinical opinion. Journal of Clinical Oncology, 40(11), 1231–1258. https://doi.org/10.1200/JCO.21.02767

Cirillo, M., Musola, M., Cassandrini, P. A., Lunardi, G., & Venturini, M. (2012). Irinotecan during pregnancy in metastatic colon cancer. Tumori, 98(6), 155e–7e. https://doi.org/10.1700/1217.13511

Demir, R., Seval, Y., & Huppertz, B. (2007). Vasculogenesis and angiogenesis in the early human placenta. Acta Histochemica, 109(4), 257–265. https://doi.org/10.1016/j.acthis.2007.02.008

Dogan, N. U., Tastekin, D., Kerimoglu, O. S., Pekin, A., & Celik, C. (2013). Rectal cancer in pregnancy: A case report and review of the literature. Journal of Gastrointestinal Cancer, 44(3), 354–356. https://doi.org/10.1007/s12029-012-9463-5

Esposito, S., Tenconi, R., Preti, V., Groppali, E., & Principi, N. (2016). Chemotherapy against cancer during pregnancy: A systematic review on neonatal outcomes. Medicine, 95(38), e4899. https://doi.org/10.1097/MD.0000000000004899

Fidler, M. M., Gupta, S., Soerjomataram, I., Ferlay, J., Steliarova-Foucher, E., & Bray, F. (2017). Cancer incidence and mortality among young adults aged 20–39 years worldwide in 2012: A population-based study. The Lancet Oncology, 18(12), 1579–1589. https://doi.org/10.1016/S1470-2045(17)30677-0

Ge, X., Feng, Y., Tan, S., Mao, W., Wang, Y., Zhu, J., & Chen, Q. (2025). Gestational colorectal cancer: Mechanisms, treatments, and prognosis. International Journal of Cancer, 157(3), 416–426. https://doi.org/10.1002/ijc.35425

Gensheimer, M., Jones, C. A., Graves, C. R., Merchant, N. B., & Lockhart, A. C. (2009). Administration of oxaliplatin to a pregnant woman with rectal cancer. Cancer Chemotherapy and Pharmacology, 63(2), 371–373. https://doi.org/10.1007/s00280-008-0731-9

Guleria, I., & Sayegh, M. H. (2007). Maternal acceptance of the fetus: True human tolerance. Journal of Immunology, 178(6), 3345–3351. https://doi.org/10.4049/jimmunol.178.6.3345

Hahn, K. M., Johnson, P. H., Gordon, N., Kuerer, H., Middleton, L., Ramirez, M., Yang, W., Perkins, G., Hortobagyi, G. N., & Theriault, R. L. (2006). Treatment of pregnant breast cancer patients and outcomes of children exposed to chemotherapy in utero. Cancer, 107(6), 1219–1226. https://doi.org/10.1002/cncr.22081

Jeppesen, J. B., & Østerlind, K. (2011). Successful twin pregnancy outcome after in utero exposure to FOLFOX for metastatic colon cancer: A case report and review of the literature. Clinical Colorectal Cancer, 10(4), 348–352. https://doi.org/10.1016/j.clcc.2011.06.003

Johnson, H. M., Mitchell, K. B., & Academy of Breastfeeding Medicine. (2020). ABM clinical protocol #34: Breast cancer and breastfeeding. Breastfeeding Medicine, 15(7), 429–434. https://doi.org/10.1089/bfm.2020.29157.hmj

Kanate, A. S., Auber, M. L., & Higa, G. M. (2009). Priorities and uncertainties of administering chemotherapy in a pregnant woman with newly diagnosed colorectal cancer. Journal of Oncology Pharmacy Practice, 15(1), 5–8. https://doi.org/10.1177/1078155208094101

Kocián, P., de Haan, J., Cardonick, E. H., Uzan, C., Lok, C. A. R., Fruscio, R., Halaska, M. J., Amant, F., & Writing Committee of the International Network on Cancer, Infertility and Pregnancy (INCIP) on this particular manuscript. (2019). Management and outcome of colorectal cancer during pregnancy: Report of 41 cases. Acta Chirurgica Belgica, 119(3), 166–175. https://doi.org/10.1080/00015458.2018.1493821

Korakiti, A. M., Zografos, E., van Gerwen, M., Amant, F., Dimopoulos, M. A., & Zagouri, F. (2020). Long-term neurodevelopmental outcome of children after in utero exposure to chemotherapy. Cancers, 12(12), 3623. https://doi.org/10.3390/cancers12123623

Kraljević, M., Hoffmann, H., Knipprath, A., & von Holzen, U. (2014). Obstructing adenocarcinoma of the descending colon in a 31-year-old pregnant woman. International Journal of Surgery Case Reports, 5(12), 958–960. https://doi.org/10.1016/j.ijscr.2014.10.011

Krutsch, K., Adams, K., Shinwari, M., & Baucom, R. B. (2023). Persistence of oxaliplatin transfer into human milk: A case report. Breastfeeding Medicine, 18(5), 395–399. https://doi.org/10.1089/bfm.2023.0037

Lambertini, M., Peccatori, F. A., & Azim, H. A., Jr. (2015). Targeted agents for cancer treatment during pregnancy. Cancer Treatment Reviews, 41(4), 301–309. https://doi.org/10.1016/j.ctrv.2015.03.001

Leslie, K. K., Koil, C., & Rayburn, W. F. (2005). Chemotherapeutic drugs in pregnancy. Obstetrics and Gynecology Clinics of North America, 32(4), 627–640. https://doi.org/10.1016/j.ogc.2005.08.009

Makoshi, Z., Perrott, C., Al-Khatani, K., & Al-Mohaisen, F. (2015). Chemotherapeutic treatment of colorectal cancer in pregnancy: Case report. Journal of Medical Case Reports, 9, 140. https://doi.org/10.1186/s13256-015-0621-9

Menzer, C., Beedgen, B., Rom, J., Duffert, C. M., Volckmar, A. L., Sedlaczek, O., Richtig, E., Enk, A., Jäger, D., & Hassel, J. C. (2018). Immunotherapy with ipilimumab plus nivolumab in a stage IV melanoma patient during pregnancy. European Journal of Cancer, 104, 239–242. https://doi.org/10.1016/j.ejca.2018.09.008

Moran, B. J., Yano, H., Al Zahir, N., & Farquharson, M. (2007). Conflicting priorities in surgical intervention for cancer in pregnancy. The Lancet Oncology, 8(6), 536–544. https://doi.org/10.1016/S1470-2045(07)70171-7

Morice, P., Uzan, C., & Uzan, S. (2012). Cancer in pregnancy: A challenging conflict of interest. The Lancet, 379(9815), 495–496. https://doi.org/10.1016/S0140-6736(11)61814-X

National Toxicology Program. (2013). NTP monograph: Developmental effects and pregnancy outcomes associated with cancer chemotherapy use during pregnancy. NTP Monograph, (2), i–214.

Ngu, S. F., & Ngan, H. Y. (2016). Chemotherapy in pregnancy. Best Practice & Research Clinical Obstetrics & Gynaecology, 33, 86–101. https://doi.org/10.1016/j.bpobgyn.2015.10.007

Peccatori, F. A., Azim, H. A., Jr, Orecchia, R., Hoekstra, H. J., Pavlidis, N., Kesic, V., Pentheroudakis, G., & ESMO Guidelines Working Group. (2013). Cancer, pregnancy and fertility: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Annals of Oncology, 24(Suppl 6), vi160–vi170. https://doi.org/10.1093/annonc/mdt199

Pellino, G., Simillis, C., Kontovounisios, C., Baird, D. L., Nikolaou, S., Warren, O., Tekkis, P. P., & Rasheed, S. (2017). Colorectal cancer diagnosed during pregnancy: Systematic review and treatment pathways. European Journal of Gastroenterology & Hepatology, 29(7), 743–753. https://doi.org/10.1097/MEG.0000000000000863

Petruzzelli, P., Zizzo, R., Tavassoli, E., Sutera, M., Tin, M. C. F., Petruzzelli, L., Benedetto, M., D’Anna, M. R., De Paolis, P., & Menato, G. (2020). Colon adenocarcinoma during pregnancy: A case report and review of the literature. Case Reports in Obstetrics and Gynecology, 2020, 8894722. https://doi.org/10.1155/2020/8894722

Pharmacia & Upjohn Co. (2024). Irinotecan (Camptosar) package insert.

Rogers, J. E., Dasari, A., & Eng, C. (2016). The treatment of colorectal cancer during pregnancy: Cytotoxic chemotherapy and targeted therapy challenges. The Oncologist, 21(5), 563–570. https://doi.org/10.1634/theoncologist.2015-0362

Salani, R., Billingsley, C. C., & Crafton, S. M. (2014). Cancer and pregnancy: An overview for obstetricians and gynecologists. American Journal of Obstetrics and Gynecology, 211(1), 7–14. https://doi.org/10.1016/j.ajog.2013.12.002

Siegel, R. L., Kratzer, T. B., Wagle, N. S., Sung, H., & Jemal, A. (2026). Cancer statistics, 2026. CA: A Cancer Journal for Clinicians, 76(1), e70043. https://doi.org/10.3322/caac.70043

Silverstein, J., Post, A. L., Chien, A. J., Olin, R., Tsai, K. K., Ngo, Z., & Van Loon, K. (2020). Multidisciplinary management of cancer during pregnancy. JCO Oncology Practice, 16(9), 545–557. https://doi.org/10.1200/OP.20.00077

Sorouri, K., Loren, A. W., Amant, F., & Partridge, A. H. (2023). Patient-centered care in the management of cancer during pregnancy. American Society of Clinical Oncology Educational Book, 43, e100037. https://doi.org/10.1200/EDBK_100037

Syme, M. R., Paxton, J. W., & Keelan, J. A. (2004). Drug transfer and metabolism by the human placenta. Clinical Pharmacokinetics, 43(8), 487–514. https://doi.org/10.2165/00003088-200443080-00001

Turriff, A. E., Annunziata, C. M., Malayeri, A. A., Redd, B., Pavelova, M., Goldlust, I. S., Rajagopal, P. S., Lin, J., & Bianchi, D. W. (2024). Prenatal cfDNA sequencing and incidental detection of maternal cancer. The New England Journal of Medicine, 391(22), 2123–2132. https://doi.org/10.1056/NEJMoa2401029

Walsh, C., & Fazio, V. W. (1998). Cancer of the colon, rectum, and anus during pregnancy. The surgeon’s perspective. Gastroenterology Clinics of North America, 27(1), 257–267. https://doi.org/10.1016/s0889-8553(05)70356-3

Wiebe, V. J., & Sipila, P. E. (1994). Pharmacology of antineoplastic agents in pregnancy. Critical Reviews in Oncology/Hematology, 16(2), 75–112. https://doi.org/10.1016/1040-8428(94)90043-4

Wolters, V., Heimovaara, J., Maggen, C., Cardonick, E., Boere, I., Lenaerts, L., & Amant, F. (2021). Management of pregnancy in women with cancer. International Journal of Gynecological Cancer, 31(3), 314–322. https://doi.org/10.1136/ijgc-2020-001776

Xu, W., Moor, R. J., Walpole, E. T., & Atkinson, V. G. (2019). Pregnancy with successful foetal and maternal outcome in a melanoma patient treated with nivolumab in the first trimester: Case report and review of the literature. Melanoma Research, 29(3), 333–337. https://doi.org/10.1097/CMR.0000000000000586

Zagouri, F., Sergentanis, T. N., Chrysikos, D., Papadimitriou, C. A., Dimopoulos, M. A., & Bartsch, R. (2013). Trastuzumab administration during pregnancy: A systematic review and meta-analysis. Breast Cancer Research and Treatment, 137(2), 349–357. https://doi.org/10.1007/s10549-012-2368-y