Immunotherapy for cancer treatment during pregnancy

Borgers, Jessica S.W.; Heimovaara, Joosje H.; Cardonick, Elyce; Dierickx, Daan; Lambertini, Matteo; Haanen, John B.A.G.; Amant, Frédéric

doi:10.1016/s1470-2045(21)00525-8

Cited by 57 publications

(44 citation statements)

References 83 publications

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“…Immunotherapy affects the pregnant woman's immune system, so that materno-fetal adverse outcomes may occur. Therefore, it is not recommended during pregnancy and should be discussed case by case (19). Treatment by alectinib is nevertheless not recommended during pregnancy because of rarity of cases.…”

Section: Discussionmentioning

confidence: 99%

A pregnant patient with ALK‑positive non‑small cell lung cancer treated with alectinib: A case report and review of the literature

et al. 2022

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Oncogenic rearrangements in the anaplastic lymphoma kinase (ALK) gene account for 5% of non-small cell lung cancer (NSCLC) cases. ALK inhibitors have markedly improved the outcome of metastatic ALK-positive NSCLC (ALK + mNSCLC) by increasing long-term overall survival. Although a diagnosis of NSCLC during pregnancy or the peripartum period is rare, ALK + NSCLC accounts for 38% of NSCLC cases in women of childbearing age (18-45 years old). The younger age and prolonged survival of patients with ALK + mNSCLC bring new challenges for lung cancer and obstetrics research, and raises questions related to pregnancy and family planning. The present study described normal fetal development and no obstetric complications in a patient infected with HIV diagnosed with ALK + mNSCLC, who became pregnant during treatment with alectinib, a third-generation ALK inhibitor.

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Section: Discussionmentioning

confidence: 99%

A pregnant patient with ALK‑positive non‑small cell lung cancer treated with alectinib: A case report and review of the literature

et al. 2022

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“…First, the administration doses and frequencies of PD-1 antibodies in clinical settings are much lower and less than those in experimental settings. Even when exposed to high doses of PD-1 antibody, animals did not present increasing risks of fetal malformations, immunodeficiencies or neurological complications ( 30 ). Second, the effect of PD-1 antibody on the fetus is subject to the interval between the last dose of the antibody and the start of pregnancy.…”

Section: Discussionmentioning

confidence: 99%

Case report: Reproductive organ preservation and subsequent pregnancy for an infertility patient with lynch syndrome-associated synchronous endometrial cancer and colon cancer after treatment with a PD-1 checkpoint inhibitor

Cao

Gao²,

Zhang³

et al. 2022

Front. Immunol.

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Currently, immune checkpoint inhibitors (ICIs) are the mainstay of treatment for Lynch syndrome patients. However, the tumor regression features in radiology and pathology are inconsistent for patients who are treated with ICIs, which sometimes confuses surgical decision-making. Here, we report a case in which a 36-year-old patient suffering from infertility was diagnosed with Lynch syndrome-associated synchronous endometrial cancer and colon cancer, and persistently enlarged left iliac paravascular lymph nodes were detected after receiving sintilimab treatment, a programmed cell death 1 (PD-1) receptor inhibitor. Fortunately, when she was about to undergo hysterectomy and bilateral salpingo-oophorectomy, intraoperative pathology examination did not reveal any cancer cells in these lymph nodes, and therefore, her reproductive organs were preserved. Later, the patient successfully conceived and gave birth to a healthy male neonate with no immune-related adverse events (irAEs) during an 11-month follow-up. This case indicates that surgeons should carefully inspect the imaging characteristics after immunotherapy and that organ preservation is possible even for patients who fail to achieve complete clinical regression, which is especially important for female patients of childbearing age.

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“…Information on whether pregnancy would increase the risk of recurrence or consequences of immunotherapy on a future pregnancy was also requested. The CIP-MDT recommended delaying conception to at least six months after treatment, based on biological aspects of the tumour and targeted and immunotherapeutic agents, case reports and available literature [17]. Surgery during pregnancy was recommended for 83.3%, e.g.…”

Section: Melanomamentioning

confidence: 99%

Ten-year experience of a national multidisciplinary tumour board for cancer and pregnancy in the Netherlands

Heimovaara

Haan²,

Calsteren³

et al. 2022

European Journal of Cancer

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Immunotherapy for cancer treatment during pregnancy

Cited by 57 publications

References 83 publications

A pregnant patient with ALK‑positive non‑small cell lung cancer treated with alectinib: A case report and review of the literature

A pregnant patient with ALK‑positive non‑small cell lung cancer treated with alectinib: A case report and review of the literature

Case report: Reproductive organ preservation and subsequent pregnancy for an infertility patient with lynch syndrome-associated synchronous endometrial cancer and colon cancer after treatment with a PD-1 checkpoint inhibitor

Ten-year experience of a national multidisciplinary tumour board for cancer and pregnancy in the Netherlands

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