First Case Report of Pregnancy on Alectinib in a Woman With Metastatic ALK-Rearranged Lung Cancer: A Case Report

Scarfone, Giovanna; Fumagalli, Monica; Imbimbo, Martina; Ceruti, Tommaso; Cribiù, Fulvia Milena; Loreto, Eugenia Di; D’Incalci, Maurizio; Facchin, Federica; Fontana, Camilla; Garassino, Marina Chiara; Peccatori, Fedro Alessandro; Persico, Nicola; Signorelli, Diego; Zucchetti, Massimo

doi:10.1016/j.jtho.2021.02.005

Cited by 21 publications

(13 citation statements)

References 7 publications

(6 reference statements)

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“…These patients produced very positive results, similar to those of nonpregnant patients, thus we speculate ALK-Is treatment may be successfully used after delivery (43,50). Significantly, of the nine patients, two were treated with crizotinib for a short period of time at the late pregnancy stage (48,49), while only one received treatment with alectinib during the entire pregnancy (47). No evidence of abnormal fetal development due to ALK-Is during pregnancy was found.…”

Section: Discussionsupporting

confidence: 52%

Case Report: A Pregnant Woman Diagnosed as ALK-Rearrangement Lung Large Cell Neuroendocrine Cancer With Brain Metastasis

Zhu

Wang

et al. 2022

Front. Oncol.

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Concomitant malignant tumors and pregnancy present many difficult questions to both clinicians and patients. Due to no specific guidelines, each aspect of clinical management requires special considerations. This current report presents a rare case of a 38-year-old pregnant woman at gestational age 33 weeks with complaints of weakness of her right limbs for 2 weeks. After successive cesarean section and craniotomy, a diagnosis of lung large cell neuroendocrine carcinoma (LCNEC) metastatic to the brain was eventually made. Next generation sequencing (NGS) showed ALK-EML4 gene fusion. Immediately afterwards she was started on the targeted therapy with the ALK inhibitor alectinib. Ten months later, all known lesions exhibited a rapid regression, and no new brain metastases were found. Consequently, the therapeutic effect was considered as a partial response. Then, we review the previous literature using PubMed on maternal malignant brain tumors diagnosed during pregnancy, or lung LCNEC associated with ALK fusion, or ALK inhibitors treatment among the pregnant women, eventually, and discuss the concerns of dealing with these patients.

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Section: Discussionsupporting

confidence: 52%

Case Report: A Pregnant Woman Diagnosed as ALK-Rearrangement Lung Large Cell Neuroendocrine Cancer With Brain Metastasis

Zhu

Wang

et al. 2022

Front. Oncol.

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“…Only one other case of pregnancy during an alectinib treatment has been described in the literature, with a continuation of the treatment until delivery. The fetal and child development until 20 months were normal and uneventful (27). The balance between fetal and maternal benefits and risks illustrates the dilemma faced in this specific and rare situation.…”

Section: Discussionmentioning

confidence: 96%

A pregnant patient with ALK‑positive non‑small cell lung cancer treated with alectinib: A case report and review of the literature

et al. 2022

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Oncogenic rearrangements in the anaplastic lymphoma kinase (ALK) gene account for 5% of non-small cell lung cancer (NSCLC) cases. ALK inhibitors have markedly improved the outcome of metastatic ALK-positive NSCLC (ALK + mNSCLC) by increasing long-term overall survival. Although a diagnosis of NSCLC during pregnancy or the peripartum period is rare, ALK + NSCLC accounts for 38% of NSCLC cases in women of childbearing age (18-45 years old). The younger age and prolonged survival of patients with ALK + mNSCLC bring new challenges for lung cancer and obstetrics research, and raises questions related to pregnancy and family planning. The present study described normal fetal development and no obstetric complications in a patient infected with HIV diagnosed with ALK + mNSCLC, who became pregnant during treatment with alectinib, a third-generation ALK inhibitor.

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“…2 There are currently only three reports of ALK inhibitor use during pregnancy, one with alectinib and two with crizotinib. [3][4][5] Owing to the unique and complex nature of this clinical scenario, a multidisciplinary team was involved, including MFM and medical oncology. Cancer during pregnancy presents both a medical and ethical challenge, as treatment decisions affect two patients.…”

Section: Discussionmentioning

confidence: 99%

“…Although ALK inhibitors are routinely used to treat ALK-rearranged NSCLC, there are limited safety data regarding use during pregnancy and fetal effects. 2,3 Here, we report the second case of a patient with metastatic ALK-rearranged lung adenocarcinoma treated with alectinib throughout pregnancy. This patient provided informed consent by means of Vanderbilt Institutional Review Board protocol #030763 for this case report.…”

Section: Introductionmentioning

confidence: 93%

Two Uncomplicated Pregnancies on Alectinib in a Woman With Metastatic ALK-Rearranged NSCLC: A Case Report

Weidenbaum

Cann

Osmundson

et al. 2022

JTO Clinical and Research Reports

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First Case Report of Pregnancy on Alectinib in a Woman With Metastatic ALK-Rearranged Lung Cancer: A Case Report

Cited by 21 publications

References 7 publications

Case Report: A Pregnant Woman Diagnosed as ALK-Rearrangement Lung Large Cell Neuroendocrine Cancer With Brain Metastasis

Case Report: A Pregnant Woman Diagnosed as ALK-Rearrangement Lung Large Cell Neuroendocrine Cancer With Brain Metastasis

A pregnant patient with ALK‑positive non‑small cell lung cancer treated with alectinib: A case report and review of the literature

Two Uncomplicated Pregnancies on Alectinib in a Woman With Metastatic ALK-Rearranged NSCLC: A Case Report

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