The American Society of Clinical Oncology (ASCO) has published updated clinical practice guidance addressing the management of cancer in pregnant patients, with the aim of consolidating current evidence and expert consensus to support multidisciplinary care in this complex setting.
The guideline, published in the Journal of Clinical Oncology, reviews the available evidence on diagnostic approaches, treatment options, and supportive care considerations when cancer is diagnosed during pregnancy. It is intended to help clinicians balance maternal health needs with foetal safety throughout the continuum of care.
CLINICAL SUMMARY
What was examined
An updated ASCO clinical practice guideline evaluating the management of cancer during pregnancy, integrating available evidence and expert consensus to support diagnosis, treatment, and multidisciplinary care.
Key findings
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Cancer treatment during pregnancy can be feasible in selected settings, with timing and regimen selection guided by gestational age, tumour type, and maternal clinical need.
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Certain systemic therapies may be considered after the first trimester, while others remain contraindicated due to foetal risk.
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Safe diagnostic imaging and staging approaches can be used when clinically necessary, with appropriate risk mitigation strategies.
Clinical implications
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Care should be delivered through a coordinated multidisciplinary model involving oncology, obstetrics, maternal–foetal medicin,e and neonatal teams.
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Treatment planning requires individualised risk–benefit assessment, balancing maternal disease control with foetal safety.
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The guideline provides a structured framework to support consistent, evidence-informed decision-making in a clinically complex and low-evidence setting.
Cancer during pregnancy presents unique clinical challenges, due in part to the need to reconcile effective anti-cancer therapy with potential risks to the developing foetus. Historically, data in this area have been limited, and practice has often relied on small case series, registry observations, and expert opinion. This guideline represents one of the most comprehensive efforts to bring current evidence together with practical recommendations for clinicians.
Key elements of the guideline include:
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Diagnosis and staging — guidance on safely performing necessary imaging and pathology assessments while minimising risk to the foetus.
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Treatment considerations — recommendations on chemotherapy timing and agents that may be considered during pregnancy, with differentiation by cancer type and gestational age.
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Multidisciplinary care — emphasis on collaborative planning among oncology, obstetrics, maternal-foetal medicine,e and paediatric specialists.
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Supportive care — consideration of maternal symptoms, anaemia management, NT, and psychosocial support.
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The guideline also highlights areas where evidence remains limited and suggests priorities for future research to improve clinical decision-making in this specialised population.
ASCO has made the full guideline and supporting tools available through its clinical resources, with the intent that these recommendations be integrated into practice settings caring for pregnant individuals diagnosed with cancer.
Paper: Loren, A.W., et al. Management of Cancer During Pregnancy: ASCO Guideline. J Clin Oncol 44, 200-251(2026). Access online here.
