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Case Reports
. 2023 Mar 24:13:1108124.
doi: 10.3389/fonc.2023.1108124. eCollection 2023.

Case report: Osimertinib administration during pregnancy in a woman with advanced EGFR-mutant non-small cell lung cancer

Pamela Soberanis Pina  1 , Luis Lara-Mejía  1 , Venecia Matias-Cruz  1 , Feliciano Barrón  1 , Andrés F Cardona  2 , Luis E Raez  3 , Eduardo Rios-Garcia  1 , Oscar Arrieta  1
Affiliations
Case Reports

Case report: Osimertinib administration during pregnancy in a woman with advanced EGFR-mutant non-small cell lung cancer

Pamela Soberanis Pina et al. Front Oncol. .

Abstract

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 EGFR 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.

Keywords: EGFR-TKI; case report; lung adenocarcinoma; metastatic disease; pregnancy.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
(A) Baseline PET-CT showed nodular thickening of the left parietal pleura, lung lesion in the left upper segment, and loculated pleural effusion. (B) PET-CT after SBRT revealed an increase in size and 18-FDG uptake. (C) PET-CT after 34 months of afatinib with complete response.
Figure 2
Figure 2
(A) First ultrasound at 10.5 weeks of gestation without alterations. (B, C) Normal structural ultrasound at 15.4 weeks of gestation (according to the last menstrual period). Average fetometry of 15.5 weeks for a weight of 124 g.
Figure 3
Figure 3
Timeline of clinical events from diagnosis to last follow-up appointment.
See this image and copyright information in PMC

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