[en] Use of Lorlatinib, a third-generation tyrosine kinase inhibitor currently indicated in the treatment of non-small-cell lung cancer (NSCLC) with ALK or ROS1 gene fusion, is formally contra-indicated during pregnancy due to teratogenic effects observed during pre-clinical studies. We report the case of a 38-year-old woman with a ROS1-positive NSCLC, successfully treated with lorlatinib as second line therapy, who became pregnant while on treatment. Due to significant disease progression 12 weeks after lorlatinib stop and the great uncertainty on the pregnancy outcome, she finally decided to interrupt the pregnancy at 22 weeks of gestation. Echography and gross infant examination did not reveal any malformation. Pregnancies occurring under this kind of new oncologic treatment is expected to happen more frequently in the future. It seems therefore important to us to report any information on the topic to increase our level of knowledge and improve decision-making.
Disciplines :
Oncology
Author, co-author :
Mawet, Marie ; Centre Hospitalier Universitaire de Liège - CHU > > Service de gynécologie-obstétrique
Basse, Clémence; Institut du Thorax Curie Montsouris, 75005, Paris, France
Barrois, Mathilde; Department of Gynecology and Obstetrics, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, 75014, Paris, France
Gligorov, Joseph; Department of Oncology, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, 75020, Paris, France
Cadranel, Jacques; Department of Oncology, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, 75020, Paris, France
Chabbert-Buffet, Nathalie; Department of Gynecology and Obstetrics, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, 75020, Paris, France
Selleret, Lise; Department of Gynecology and Obstetrics, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, 75020, Paris, France
Language :
English
Title :
Second-trimester medical abortion after exposure to lorlatinib during early pregnancy, a case report.
Publication date :
December 2023
Journal title :
Journal of Gynecology Obstetrics and Human Reproduction
Ferlay, J, Colombet, M, Soerjomataram, I, et al. Estimating the global cancer incidence and mortality in 2018: GLOBOCAN sources and methods. Int J Cancer 144:8 (2019), 1941–1953, 10.1002/ijc.31937 Apr 15.
Solomon, BJ, Bauer, TM, Mok, TSK, et al. Efficacy and safety of first-line lorlatinib versus crizotinib in patients with advanced, ALK-positive non-small-cell lung cancer: updated analysis of data from the phase 3, randomised, open-label CROWN study. Lancet Respir Med, 2022, 10.1016/S2213-2600(22)00437-4 Dec 16.
Bergethon, K, Shaw, AT, Ou, SH, et al. ROS1 rearrangements define a unique molecular class of lung cancers. J Clin Oncol 30:8 (2012), 863–870, 10.1200/JCO.2011.35.6345 Mar 10.
Rimkunas, VM, Crosby, KE, Li, D, et al. Analysis of receptor tyrosine kinase ROS1-positive tumors in non-small cell lung cancer: identification of a FIG-ROS1 fusion. Clin Cancer Res 18:16 (2012), 4449–4457, 10.1158/1078-0432.CCR-11-3351 Aug 15.
Lorviqua 25 mg Summary of product characteristics. Accessed 05/02, 2023.
Barlesi, F, Mazieres, J, Merlio, JP, et al. Routine molecular profiling of patients with advanced non-small-cell lung cancer: results of a 1-year nationwide programme of the French Cooperative Thoracic Intergroup (IFCT). Lancet 387:10026 (2016), 1415–1426, 10.1016/S0140-6736(16)00004-0 Apr 2.
Scarfone, G, Fumagalli, M, Imbimbo, M, et al. First Case Report of Pregnancy on Alectinib in a Woman With Metastatic ALK-Rearranged Lung Cancer: A Case Report. J Thorac Oncol 16:5 (2021), 873–877, 10.1016/j.jtho.2021.02.005 May.
Boudy, AS, Grausz, N, Selleret, L, et al. Use of tyrosine kinase inhibitors during pregnancy for oncogenic-driven advanced non-small cell lung carcinoma. Lung Cancer 161 (2021), 68–75, 10.1016/j.lungcan.2021.09.001 Nov.