How would you approach treatment for a patient in the early third trimester of pregnancy who is newly diagnosed with cT2N0 triple-negative breast cancer (TNBC)?

Since the patient is in her third trimester, chemotherapy administration should be safe. We do not have a lot of safety data for the use of pembrolizumab in pregnant women. However, exposing a pregnant woman to an immune checkpoint inhibitor carries at least a theoretical concern that it may disrupt...

I would treat her with weekly paclitaxel and carboplatin, either every week (unless she has neutropenia or other toxicity requiring treatment delay) or, preferentially, days 1,8 and 15 every 28 days as in the PATTERN adjuvant trial. She cannot receive immunotherapy during pregnancy, but this could b...