How would you treat a pregnant woman in the third trimester with locally advanced, hormone receptor positive, HER2 positive breast cancer?

Given good amount of safety data on anthracycline therapy during pregnancy, favor doxorubicin cyclophosphamide x 3-4 cycles (depending on time of delivery) given every 3 weeks without peg-filgrastim support. With less data with growth factor support, lean toward avoiding in this situation. Will avoid anti-Her2 therapy during pregnancy due to increased risk of oligohyroamnios. some limited safety data is available on taxane but not as well supported as anthracycline so in my practice I generally ...

I would say, FAC regimen (5-fluorouracil, Adriamycin and Cyclophosphamide) has one of the best data during 2nd/3rd trimester based on MD Anderson's prospective cohort published data

Hahn KM, Johnson PH, Gordon N, et al. Treatment of pregnant breast cancer patients and outcomes of children exposed to chemotherapy in utero. Cancer. 2006;107(6):1219–1226.

I agree with continuing to hold off on Taxanes during pregnancy, even though there are several published case reports and systemic reviews showing ...