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- Placenta rate: scientists have obtained important data on cancer treatment in pregnant women
Placenta rate: scientists have obtained important data on cancer treatment in pregnant women
Russian scientists are conducting research on the molecular and genetic characteristics of pregnant women with cancer and have identified a number of patterns. Cancer treatment during pregnancy is one of the most poorly understood issues in oncology, experts emphasized. The work of scientists will make it possible to identify certain mutations or other rearrangements that can either be targets, prognostic factors, or serve as the basis for developing tests, experts interviewed by Izvestia believe.
Oncological diseases in pregnant women
Scientists of the IBHF RAS, together with the staff of the V.I. Kulakov National Research Medical Center of the Russian Academy of Medical Sciences, are conducting research on the molecular and genetic characteristics of pregnant women with oncological diseases. This was reported to Izvestia by the press service of the Ministry of Education and Science.
According to the developers, the treatment of oncological diseases during pregnancy is one of the most poorly understood issues in oncology, and therapeutic tactics for such patients remain controversial.
Scientists named breast cancer (breast cancer), cervical cancer (breast cancer), and ovarian cancer (ovarian cancer) as the most common. At the first stage of treatment, cytostatic chemotherapy is used as standard in these patients, based on the use of drugs that inhibit the reproduction (more precisely, clonal proliferation) of malignant cells.
The team's research is devoted to identifying the expression features of genes related to the glutathione system, involved in the neutralization of compounds entering the body, and the main transport protein in the placenta of pregnant women with breast cancer, breast cancer, and breast cancer.
"A comprehensive study of the molecular genetic characteristics of patients with oncological diseases that developed during pregnancy, the first step towards which was taken in our work, is aimed at developing approaches to individualize the treatment of these patients," Tatiana Zavarykina, head of the Group of Molecular Genetic Research at the IBHF RAS, told Izvestia.
The glutathione system is one of the main enzymatic systems of the body, which plays an important role in placental metabolism. Glutathione transferases are involved in the conversion of compounds that enter the body and are responsible for the neutralization of a wide range of toxins and drugs. The glutathione transferase genes GSTP1 and GSTT1 encode key enzymes of this system.
Proteins responsible for their transport through the plasma membrane of the cell are closely related to the transport of medicinal substances used in the treatment of oncological diseases. These include the superfamily of ABC transporters. It is known that these specific drug carrier proteins are key factors in the drug resistance of tumors and the characteristics of their response to treatment.
The team of scientists determined the relative expression of the ABCB1, GSTP1 and GSTT1 genes by real-time PCR in pregnant women with cancer who received cytostatic chemotherapy, relative to healthy pregnant women.
Cancer therapy in pregnant women
In their research, scientists have identified a change in gene expression in the placenta of pregnant women with cancer. The results indicate that an active process is taking place in the placental tissue, possibly related to the protective mechanism of this organ in relation to the fetus.
The continuation of the work is of high practical importance, the scientists emphasized, since the study of the molecular and genetic characteristics of pregnant women with cancer can reveal new therapy targets, prognostic markers of obstetric complications of breast cancer treatment, and opportunities for evaluating the effectiveness of chemotherapy during pregnancy. The work was supported by the Ministry of Education and Science of the Russian Federation.
The problem of cancer treatment in pregnant women has a number of difficulties. First of all, this is the absence or insufficient amount of reliable scientific data on the effectiveness and safety of certain methods, Maxim Kotov, market expert at NTI Helsnet, oncologist at the N.N. Petrov National Research Medical Center of Oncology, told Izvestia.
— The fact is that all protocols of clinical trials aimed at studying the effectiveness and safety of antitumor therapy contain pregnancy as an exclusion criterion. Studying the molecular and genetic characteristics of pregnant women with cancer may make it possible to identify certain mutations or other rearrangements that may be either therapeutic targets, prognostic factors, or may serve as the basis for the development of diagnostic tests," he said.
The difficulty of studying lies primarily in the fact that oncological diseases during pregnancy are quite rare, so it is problematic to recruit the necessary number of participants for research. It is also important to consider the effect of treatment methods on the embryo or fetus, the specialist emphasized.
Such studies are important and necessary, because cancer can actually occur during pregnancy, if there is a corresponding predisposition, or a disease that was previously invisible may manifest itself. This can happen due to hormonal changes occurring in the body, said Andrey Lomonosov, Deputy head of the NTI "HealthNet" working group on Biomedicine, scientific consultant at R-Pharm JSC.
— The risk is higher for women who give birth after 35 years, but you need to understand that this does not happen to everyone. To date, there is no clear and confident understanding of who exactly is at increased risk. Research should help us figure this out. Then women at high risk will be able to do additional examinations. During pregnancy or in the postpartum period, it is difficult to suspect breast cancer, for example, because it is changing. A woman cannot independently notice the pathology in the early stages and consult a doctor in a timely manner, so treatment is often delayed when the cancer is already at a late stage," he said.
Given the steady increase in the number of women with their first pregnancy after the ages of 30 and 35, a trend that will only intensify in the future, studies of genetic characteristics are needed to identify high—risk patients, the expert emphasized.
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