Management of Cancer During Pregnancy: ASCO Guideline
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.
Authors
- Katherine Van Loon (ORCID: https://orcid.org/0000-0002-9705-4114)
- Jane E. Rogers (ORCID: https://orcid.org/0000-0002-7275-7008)
- Frédéric Amant (ORCID: https://orcid.org/0000-0002-5452-4905)
- Rachel Raab
- Jolyn Taylor (ORCID: https://orcid.org/0000-0003-1267-4371)
- Christina Lacchetti (ORCID: https://orcid.org/0000-0001-6500-713X)
- Ann H. Partridge (ORCID: https://orcid.org/0000-0002-4722-4824)
- Don S. Dizon (ORCID: https://orcid.org/0000-0001-6541-9580)
- Alison W. Loren (ORCID: https://orcid.org/0000-0002-8812-9911)
- Elyce Cardonick (ORCID: https://orcid.org/0000-0003-2203-3367)
- Tatiana M. Prowell (ORCID: https://orcid.org/0000-0002-8065-3399)
- William H. Wallace (ORCID: https://orcid.org/0000-0001-8080-5674)
- Lisa A. Carey (ORCID: https://orcid.org/0000-0003-2388-4649)
- Mikkael Aaron Sekeres (ORCID: https://orcid.org/0000-0003-2009-6524)
- Hina Saeed (ORCID: https://orcid.org/0000-0001-7751-3494)
- Mélissa Henry (ORCID: https://orcid.org/0000-0002-0642-0888)
- Nicole Christian (ORCID: https://orcid.org/0000-0001-8498-1819)
- Julia Maués (ORCID: https://orcid.org/0000-0002-4478-6952)
- Siddhartha Yadav (ORCID: https://orcid.org/0000-0003-4630-9903)
- Melissa M. Hudson (ORCID: https://orcid.org/0000-0001-6984-2407)
- Caroline C. Clark (ORCID: https://orcid.org/0009-0001-3272-2054)
- Erika Peterson
- Katie Watson
Institutions
- Northwestern University (US)
- University of North Carolina at Chapel Hill (US)
- Tufts University (US)
- St. Jude Children's Research Hospital (US)
- American Society of Clinical Oncology (US)
- Oncology Nursing Society (US)
- The University of Texas MD Anderson Cancer Center (US)
- University of Miami (US)
- University of California, San Francisco (US)
- Florida International University (US)
- Medical College of Wisconsin (US)
- Baltimore City Health Department (US)
- Dana-Farber Cancer Institute (US)
- Mayo Clinic in Arizona (US)
- Sylvester Comprehensive Cancer Center (US)
- Cooper University Health Care (US)
- Sidney Kimmel Comprehensive Cancer Center (US)
- McGill University (CA)
- University of Pennsylvania (US)
- University of Colorado Denver (US)
- University of Edinburgh (GB)
Publication Details
- Journal
- Journal of Clinical Oncology
- Published
- 2025-12-11
- DOI
- https://doi.org/10.1200/jco-25-02115
- Citations
- 1
- Primary Topic
- Cancer Risks and Factors
- Type
- article
- Field-Weighted Citation Impact
- 1.05