ALK Rearrangement Positive Lung Adenocarcinoma in Pregnancy Treated With Alectinib: A Case Report

• Published in: Clinical lung cancer 2024-03, Vol.25 (2), p.e77-e80
• Main Authors: Gonzalez-Mosquera, Luis F., Rous, Fawzi Abu, Rogers, Alexandra, Smith, Nicolina, Goyert, Gregory, Gadgeel, Shirish
• Format: Article
• Language: English
• Subjects: Adenocarcinoma; Adenocarcinoma of Lung - drug therapy; Adenocarcinoma of Lung - genetics; Adult; Alectinib; Anaplastic lymphoma kinase; Anaplastic Lymphoma Kinase - genetics; Carbazoles - therapeutic use; Carcinoma, Non-Small-Cell Lung - drug therapy; Carcinoma, Non-Small-Cell Lung - genetics; Carcinoma, Non-Small-Cell Lung - pathology; Female; Humans; Lung Neoplasms - diagnosis; Lung Neoplasms - drug therapy; Lung Neoplasms - genetics; Metastatic lung cancer; Piperidines; Pregnancy; Protein Kinase Inhibitors - therapeutic use; Receptor Protein-Tyrosine Kinases - genetics
• ISSN: 1525-7304; 1938-0690
• DOI: 10.1016/j.cllc.2023.11.006

There are few reported cases of ALK gene rearranged (ALK+) non–small cell lung cancer (NSCLC) during pregnancy. There is a lack of information on the safety of ALK inhibitors in pregnant patients. We present a 25-year-old African American woman who was diagnosed with metastatic ALK+ lung adenocarcinoma at 15 weeks of gestation. Treatment with alectinib was initiated at 18 weeks' gestation with resultant radiological treatment response. The patient did not experience any adverse effects from alectinib during her pregnancy. An elective induction of labor at 39 weeks resulted in an uncomplicated vaginal delivery. This case adds to available data and provides insight on the safety of using alectinib in a pregnant, ALK+ NSCLC patient, allowing the patient to continue her pregnancy to term while treating advanced lung adenocarcinoma.