Case reportUse of erlotinib throughout pregnancy: A case-report of a patient with metastatic lung adenocarcinoma
Introduction
The diagnosis of cancer and pregnancy is an emotional challenge and entails an ethical dilemma for the patient, her family, physicians and society [1]. The incidence of cancer and pregnancy is approximately 1 in 1000 pregnancies [2]. To our knowledge only 44 cases of women with lung cancer during pregnancy have been published, more than 80% corresponding to stages III and IV, with a median survival of 4.5 months. Only 9 achieved survival larger than 1 year and 26% had documented metastasis to the products of conception [1], [3]. There is only one report on the use of erlotinib during the first 8 weeks of gestation [4].
We report on the first case of a patient with stage IV lung adenocarcinoma in whom a fourteen-week pregnancy had been documented under erlotinib treatment. The patient has achieved partial response, and the baby is in good health.
Section snippets
Case description
A forty year-old female with no smoking history presented with two months of dry cough and moderate exertion dyspnea which was followed by chest pain. A chest X-ray revealed a left lower lobe infiltrate interpreted as pneumonia and treated with clarithromycin with no improvement. Given the persistence of symptoms a computed tomography was obtained and a transbronchial biopsy performed which confirmed the diagnosis of non-mucinous bronchioloalveolar carcinoma with multiple pulmonary and
Discussion
Lung cancer is the fourth most frequent cause of cancer and the second cause of cancer death in women worldwide [5]. Patients with stage IV lung adenocarcinoma have a poor prognosis with a median survival of 5 months and a global survival of 23.3% at 1 year and 9.9% at 2 years [6].
To our knowledge only 44 cases of women with lung cancer during pregnancy have been published, 90% corresponding to advanced illness and thus were not candidates for surgical treatment. Most patients had a bad postpartum
Conflict of interest statement
The authors declare no conflicts of interest.
Acknowledgements
We would like to thank Dr. Oswaldo Sánchez member of the Clinical Oncology Group at Cancerology National Institute and Dr. Alfonso Lozano member of the Radiology Group at Cancerology National Institute, Bogota, Colombia.
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