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General Updates | The use of immunotherapies for the treatment of hematologic malignancies during pregnancy
Daan Dierickx, MD, PhD, KU Leuven and University Hospitals Leuven, Leuven, Belgium, discusses considerations for clinicians when using novel therapies, such as immunotherapies and antibody-based treatments, to treat a hematologic malignancy during pregnancy, noting that data in this setting are limited. Prof. Dierickx highlights that monoclonal antibodies can be safely administered during the first and second trimester, but advises against administration from the 32nd week onwards due to potential risks. This interview took place virtually.
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Transcript
The data are indeed more limited compared to chemotherapy, and it’s also a different context. So for example, when you consider monoclonal antibodies, which are often part of immunotherapy, actually the first 12 to 14 weeks, there is no transfer of immunoglobulins through the placenta. So at that time, you can give it safely, actually, during the first trimester...
The data are indeed more limited compared to chemotherapy, and it’s also a different context. So for example, when you consider monoclonal antibodies, which are often part of immunotherapy, actually the first 12 to 14 weeks, there is no transfer of immunoglobulins through the placenta. So at that time, you can give it safely, actually, during the first trimester. But you see that the transfer increases when the pregnancy is growing. So for immunotherapy, not for all immunotherapies, but for monoclonal antibodies, actually, you can give it safely during the first and second trimester, but we actually advise not to give it from the 32nd week on, because we know it can pass the placenta, and there are some reports of pregnant patients who received checkpoint inhibition during the pregnancy, in which the baby afterwards develops an autoimmune complication. So it’s very important to know that it’s actually different compared to chemotherapy, where you never give it during the first trimester, actually, for the monoclonal antibody, it’s important not to give it at the end of the pregnancy or if you need to give it to be very careful.
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