Successful pregnancy with epidermal growth factor receptor tyrosine kinase inhibitor treatment of metastatic lung adenocarcinoma presenting with respiratory failure

Clinicopathologic Features of NSCLC Diagnosed During Pregnancy or the Peripartum Period in the Era of Molecular Genotyping

“…The majority of published cases of NSCLC diagnosed during pregnancy in never or light smokers with molecular testing available harbored EGFR mutations. 15, 16, 17, 18 However, in our series, among the different molecular subgroups, ALK -positive NSCLC predominated. This discrepancy may be explained by the rarity of pregnancy/peripartum diagnosis of NSCLC, the relatively recent identification of ALK as an oncogenic driver, younger age of patients with ALK -positive NSCLC relative to other genotypes, variation in frequency of testing for ALK rearrangements across institutions, referral bias, and reporting bias.…”

“…Treatment with TKIs may account for the improved outcomes seen in our series and recently published case reports. 15, 16, 17, 18, 19, 20 Indeed, most of the patients reported in our series are alive over 2 years after their lung cancer diagnosis (Table 3). Little, however, is known about the safety of targeted agents during pregnancy.…”

Efficacy and safety of gefitinib during pregnancy: Case report and literature review

“…However drug administration was initiated without knowledge of ongoing pregnancy as chemotherapy should not be administered during the first trimester because of a high risk of congenital malformations [1] These three cases confirmed a good rate of response and rapid efficacy on respiratory distress associated with no fetal adverse events and a good outcome for children as demonstrated in Table 1 [8][9][10]. Finally, taking into account that TKIs could improve the mother's respiratory distress more efficiently than cytotoxic chemotherapy and thus avoid a immediate fetal extraction and its morbidity, we then urgently began gefitinib treatment for both reasons.…”

Use of erlotinib throughout pregnancy: A case-report of a patient with metastatic lung adenocarcinoma

“…The EURTAC study reported a progression-free survival of patients treated with erlotinib of 9.4 months vs. 5.2 months for those treated with chemotherapy HR, 0.42; p < 0.0001 [7]. The OPTI-MAL study reported that patients under erlotinib had a median progression-free survival of 12.1 months compared to 4.6 months for the group treated with chemotherapy HR 0.16, 95% CI 0.10-0.26; p = 0.0001 [8].…”

“…Nowadays tyrosine kinase inhibitors such as erlotinib are available showing an improvement in progression-free survival, as first line treatment in patients with metastatic lung adenocarcinoma with EGFR mutations in exons 10 or 21 [7,8]. The EURTAC study reported a progression-free survival of patients treated with erlotinib of 9.4 months vs. 5.2 months for those treated with chemotherapy HR, 0.42; p < 0.0001 [7].…”