PDF(Pubmed)
Abstract：
Non-small cell lung cancer (NSCLC) occasionally develops in younger, fertile patients. This early-onset NSCLC tends to have more oncogenic driver mutations than in aged patients. Among early-onset NSCLC patients, pregnancy is very rare. However, there are some patients who were able to balance tyrosine kinase inhibitor (TKI) administration and pregnancy. Here, we report a case of a pregnancy under alectinib hydrochloride (a second-generation anaplastic lymphoma kinase (ALK)-TKI) administration throughout the entire gestational period for ALK-rearranged metastatic lung adenocarcinoma. The patient was an Asian female in her early 20s who became aware of her pregnancy after diagnosis and the start of alectinib administration. She intended to have the baby despite the necessity of continuing her treatment and the unknown risks involved. A multidisciplinary team (thoracic surgeon, obstetrics, pediatrics, and so on) was organized to support the patient, baby, and family. There were no obvious signs of tumor progression during pregnancy. She gave birth at 41 weeks and one day of gestation. There was no placental metastasis. Alectinib concentration at delivery was 155 ng/mL in maternal blood, 22.1 ng/mL in umbilical cord venous blood, 20.1 ng/mL in amniotic fluid, and 11.8 ng/mL in colostrum. The baby had been exposed to alectinib throughout the entire pregnancy; however, fetal growth curve parameters remained within the normal ranges and the baby developed without anatomical or neurodevelopmental anomalies or fetal metastasis for the first 13 months of age.
摘要：
非小细胞肺癌（NSCLC）偶尔发展在年轻，肥沃的病人。这种早发性NSCLC倾向于比老年患者具有更多的致癌驱动突变。在早发性NSCLC患者中，怀孕是非常罕见的。然而,有一些患者能够平衡酪氨酸激酶抑制剂(TKI)给药和妊娠.这里,我们报道一例在ALK重排的转移性肺腺癌的整个妊娠期间,在盐酸阿莱替尼(第二代间变性淋巴瘤激酶(ALK)-TKI)给药的情况下妊娠.该患者是一名20岁出头的亚洲女性，在诊断和开始给药后意识到自己的怀孕。尽管有必要继续治疗并且存在未知的风险，但她仍打算生孩子。多学科团队(胸外科医生，产科,儿科,等等)被组织起来支持病人，宝贝,和家庭。怀孕期间没有明显的肿瘤进展迹象。她在怀孕41周零一天分娩。无胎盘转移。分娩时母体血液中的阿莱替尼浓度为155ng/mL，脐带血22.1ng/mL，羊水中20.1ng/mL，和11.8ng/mL的初乳。婴儿在整个怀孕期间都暴露于alectinib；然而，胎儿生长曲线参数保持在正常范围内,婴儿在出生后的前13个月未出现解剖或神经发育异常或胎儿转移.
