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

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.

Automated summary

Oncogenic rearrangements in the ALK gene are responsible for 5% of NSCLC cases, and ALK inhibitors have significantly improved the outcomes in ALK(+) mNSCLC patients. ALK(+) NSCLC accounts for 38% of cases in women of childbearing age, presenting new challenges in lung cancer and obstetrics research. This study reported a case of a pregnant HIV-infected patient with ALK(+) mNSCLC who had no fetal developmental abnormalities or obstetric complications during treatment with alectinib.