Yang Lei, He Yun-Ting, Kang Jin, Zheng Ming-Ying, Chen Zhi-Hong, Yan Hong-Hong, Zhang Xu-Chao, Yang Jin-Ji, Wu Yi-Long, Zhou Qing
The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China.
Guangdong Lung Cancer Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.
J Thorac Dis. 2021 Jul;13(7):4125-4136. doi: 10.21037/jtd-21-234.
There is no standard procedure available to diagnose and treat with pregnancy-associated non-small cell lung cancer (NSCLC). The present study was to investigate the clinical and molecular features, and the proper intervention timing for this population.
This is a retrospective, pooled analysis. Cases from Guangdong Lung Cancer Institute and other published cases were collected and reviewed. The overall survival (OS) was analyzed according to the diagnosis timing, the treatment timing and the molecular character. The safety profile during pregnancy was also evaluated.
Seventy-seven cases were collected including 11 patients from our center. The anaplastic lymphoma kinase () gene rearrangement and epidermal growth factor receptor () mutation rates were 47% and 32%, respectively. The OS of patients treated during pregnancy, after delivery, and those not treated differed significantly [12 months not reached (NR) 1 month; P<0.001]. However, the OS between patients treated during pregnancy and after delivery was similar (P=0.173). Patients with or exhibited a significantly better OS than those with wild-type [NR 22 months 8 months; P<0.001; hazard ratio (HR) =0.02, 95% confidence interval (CI): 0.00-0.22; HR =0.08, 95% CI: 0.01-0.76]. Fetal complications were observed in babies whose mothers were treated during pregnancy.
The pregnancy-associated NSCLC population exhibited a high prevalence of driver genes and a promising effect of targeted therapy. No significant difference in the OS was observed between patients treated during pregnancy and patients treated after delivery.
目前尚无用于诊断和治疗妊娠相关非小细胞肺癌（NSCLC）的标准程序。本研究旨在调查该人群的临床和分子特征，以及合适的干预时机。
这是一项回顾性汇总分析。收集并回顾了来自广东省肺癌研究所的病例以及其他已发表的病例。根据诊断时机、治疗时机和分子特征分析总生存期（OS）。还评估了孕期的安全性。
共收集了77例病例，其中包括我们中心的11例患者。间变性淋巴瘤激酶（ALK）基因重排率和表皮生长因子受体（EGFR）突变率分别为47%和32%。孕期接受治疗、产后接受治疗以及未接受治疗的患者的总生存期有显著差异[12个月 未达到（NR） 1个月；P<0.001]。然而，孕期接受治疗和产后接受治疗的患者的总生存期相似（P=0.173）。携带ALK或EGFR突变的患者的总生存期明显优于野生型患者[NR 22个月 8个月；P<0.001；风险比（HR）=0.02，95%置信区间（CI）：0.00 - 0.22；HR =0.08，95%CI：0.01 - 0.76]。在母亲孕期接受治疗的婴儿中观察到了胎儿并发症。
妊娠相关NSCLC人群的驱动基因患病率较高，靶向治疗效果良好。孕期接受治疗的患者和产后接受治疗的患者的总生存期无显著差异。
