Faculty Collaboration Database

Management of Cancer During Pregnancy: ASCO Guideline. J Clin Oncol 2026 Jan 20;44(3):200-251

Date

12/11/2025

Pubmed ID

41380115

DOI

10.1200/JCO-25-02115

Scopus ID

2-s2.0-105027386696 (requires institutional sign-in at Scopus site)   20 Citations

Abstract

PURPOSE: To provide guidance on the recommended management of cancer in pregnant patients.

METHODS: A multidisciplinary Expert Panel convened and conducted a systematic review of the literature.

RESULTS: The systematic review identified 450 eligible studies. Much of the evidence consisted of observational data, case series, and case reports.

RECOMMENDATIONS: Management of cancer during pregnancy should be grounded in a values-based informed-consent process outlining maternal and fetal risks and anticipated benefits. Diagnostic evaluation should follow the as low as reasonably achievable (ALARA) principle, with timing of diagnostic studies individualized based on urgency of cancer detection, potential dangers of delay, and the balance of risks to both the pregnant patient and her embryo or fetus. Due to significant risk of harm to the developing embryo and/or fetus, systemic therapy should be deferred until the second trimester. Methotrexate, hormonal therapies, human epidermal growth factor receptor 2-targeted agents, vascular endothelial growth factor and poly (ADP-ribose) polymerase inhibitors, antibody-drug conjugates, and all cellular therapies are contraindicated during pregnancy, regardless of gestational age. For patients who wish to continue their pregnancy, delivery should be planned at or after 37 weeks, with the final chemotherapy dose scheduled 2-4 weeks before birth. Referral to psychosocial support services is essential to address emotional and practical challenges, reduce distress, and support shared decision making.Additional information is available at www.asco.org/survivorship-guidelines.

Author List

Loren AW, Lacchetti C, Amant F, Cardonick EH, Carey LA, Christian N, Clark C, Dizon DS, Henry M, Hudson MH, Maués J, Peterson E, Prowell TM, Raab R, Rogers JE, Saeed H, Sekeres MA, Taylor JS, Van Loon K, Wallace WH, Watson KL, Yadav S, Partridge AH

Author

Erika Peterson MD Professor in the Obstetrics and Gynecology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Female
Humans
Medical Oncology
Neoplasms
Pregnancy
Pregnancy Complications, Neoplastic