August 2, 2022

Targeted cancer drug during pregnancy

The targeted cancer therapy alectinib was safe as a treatment for lung cancer during two pregnancies in a patient with non-small cell lung cancer, according to a case report from Vanderbilt physicians.

Pregnancy in patients with lung cancer is uncommon. There are limited safety data during pregnancy for ALK inhibitors — targeted therapies for patients with non-small cell lung cancer (NSCLC) with ALK gene rearrangements. 

Wade Iams, MD, MSCI, Travis Osterman, DO, MS, and colleagues report the case of a patient with metastatic ALK-rearranged NSCLC who was treated with the ALK inhibitor alectinib throughout two pregnancies. 

There were no observed obstetrical complications and no postnatal complications other than newborn hyperbilirubinemia after the first pregnancy, which self-resolved. The children, ages 2 years 9 months and 10 months at the time of publication, have normal growth and development and no observed congenital abnormalities. 

The findings in JTO Clinical and Research Reports do not exclude undetectable or delayed toxic effects, the authors note. Longer-term follow-up is important for these children, and additional studies are needed regarding the safety of alectinib treatment during pregnancy.

Other authors of the study include first author Chloe Weidenbaum, DO, Christopher Cann, MD, and Sarah Osmundson, MD, MS. The research was supported by a National Comprehensive Cancer Network Young Investigator Award to Iams.