Soberanis Pina Pamela, Lara-Mejía Luis, Matias-Cruz Venecia, Barrón Feliciano, Cardona Andrés F, Raez Luis E, Rios-Garcia Eduardo, Arrieta Oscar
Thoracic Oncology Unit, Department of Thoracic Oncology, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico.
Direction of Research and Education, Luis Carlos Sarmiento Angulo Cancer Treatment and Research Center - CTIC, Bogotá, Colombia.
Front Oncol. 2023 Mar 24;13:1108124. doi: 10.3389/fonc.2023.1108124. eCollection 2023.
Lung cancer (LC) is one of the most common causes of death worldwide. The identification of oncogene-addicted driving mutations suitable for targeted therapy has improved clinical outcomes in advanced diseases. Clinical trials, on the other hand, rarely involve vulnerable groups such as pregnant women. We report a 37-year-old woman with advanced non-small cell lung cancer (NSCLC) harboring an exon 19 deletion of treated with afatinib. After the initial treatment, the patient achieved a complete response and had an unplanned pregnancy. Targeted therapy was withheld during the first trimester and resumed with osimertinib in the second trimester in which the patient developed oligohydramnios and intrauterine growth restriction (IUGR) of the baby. Osimertinib was delayed at two different times during the third trimester with complete resolution of the oligohydramnios. The baby was born at 37.3 weeks of gestation (WOG) with no signs of congenital disorders. After delivery, the mother restarted osimertinib and maintained a complete response. This case suggests that osimertinib could be an acceptable option for tumor control during pregnancy in EGFR-mutant NSCLC. This information do not replace current recommendations for avoiding pregnancy and promoting contraceptive usage in patients receiving any cancer therapy.
肺癌（LC）是全球最常见的死亡原因之一。识别适合靶向治疗的致癌基因成瘾驱动突变改善了晚期疾病的临床结局。另一方面，临床试验很少涉及孕妇等弱势群体。我们报告了一名37岁患有晚期非小细胞肺癌（NSCLC）的女性，其携带外显子19缺失，接受了阿法替尼治疗。初始治疗后，患者达到完全缓解并意外怀孕。在孕早期停用靶向治疗，在孕中期恢复使用奥希替尼，在此期间患者出现羊水过少和胎儿宫内生长受限（IUGR）。在孕晚期，奥希替尼在两个不同时间延迟使用，羊水过少完全消退。婴儿在妊娠37.3周（WOG）出生，无先天性疾病迹象。分娩后，母亲重新开始使用奥希替尼并维持完全缓解。该病例表明，对于EGFR突变的NSCLC孕妇，奥希替尼可能是控制肿瘤的可接受选择。此信息不能取代目前关于接受任何癌症治疗的患者避免怀孕和促进避孕使用的建议。
