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Zhou JP, Wang Y, Lin YN, Sun XW, Ding YJ, Yan YR, Li N, Zhang L, Li QY. Clinical Features and Management of Lung Cancer During Pregnancy: A Narrative Review Based on Reported Cases. WOMEN'S HEALTH REPORTS (NEW ROCHELLE, N.Y.) 2023; 4:544-550. [PMID: 38023372 PMCID: PMC10664570 DOI: 10.1089/whr.2023.0085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 10/27/2023] [Indexed: 12/01/2023]
Abstract
This review aims to provide a summary of the clinical characteristics and outcomes of lung cancer during pregnancy. A comprehensive literature search yielded 93 cases of lung cancer during pregnancy from 1953 to 2022, with an average maternal age of ∼34 years old. The initial symptoms reported were often nonspecific, such as cough, dyspnea, and chest pain. Cancer-related treatments, including surgery, radiotherapy, chemotherapy, and tyrosine kinase inhibitors, have shown beneficial effects on maternal outcomes. A majority of the newborns were born without malformation or diseases, but extended follow-up remains necessary. Early diagnosis of lung cancer is imperative for reducing the risks of placental and fetal metastasis and enhancing overall survival.
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Affiliation(s)
- Jian Ping Zhou
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Institute of Respiratory Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yi Wang
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Institute of Respiratory Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ying Ni Lin
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Institute of Respiratory Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xian Wen Sun
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Institute of Respiratory Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yong Jie Ding
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Institute of Respiratory Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ya Ru Yan
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Institute of Respiratory Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ning Li
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Institute of Respiratory Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Liu Zhang
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Institute of Respiratory Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qing Yun Li
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Institute of Respiratory Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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2
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Yang L, He YT, Kang J, Zheng MY, Chen ZH, Yan HH, Zhang XC, Yang JJ, Wu YL, Zhou Q. Clinical features and intervention timing in patients with pregnancy-associated non-small-cell lung cancer. J Thorac Dis 2021; 13:4125-4136. [PMID: 34422342 PMCID: PMC8339795 DOI: 10.21037/jtd-21-234] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 05/27/2021] [Indexed: 12/18/2022]
Abstract
Background There is no standard procedure available to diagnose and treat with pregnancy-associated non-small cell lung cancer (NSCLC). The present study was to investigate the clinical and molecular features, and the proper intervention timing for this population. Methods This is a retrospective, pooled analysis. Cases from Guangdong Lung Cancer Institute and other published cases were collected and reviewed. The overall survival (OS) was analyzed according to the diagnosis timing, the treatment timing and the molecular character. The safety profile during pregnancy was also evaluated. Results Seventy-seven cases were collected including 11 patients from our center. The anaplastic lymphoma kinase (ALK) gene rearrangement and epidermal growth factor receptor (EGFR) mutation rates were 47% and 32%, respectively. The OS of patients treated during pregnancy, after delivery, and those not treated differed significantly [12 months vs. not reached (NR) vs. 1 month; P<0.001]. However, the OS between patients treated during pregnancy and after delivery was similar (P=0.173). Patients with ALK or EGFR exhibited a significantly better OS than those with wild-type [NR vs. 22 months vs. 8 months; P<0.001; hazard ratio (HR) =0.02, 95% confidence interval (CI): 0.00–0.22; HR =0.08, 95% CI: 0.01–0.76]. Fetal complications were observed in babies whose mothers were treated during pregnancy. Conclusions The pregnancy-associated NSCLC population exhibited a high prevalence of driver genes and a promising effect of targeted therapy. No significant difference in the OS was observed between patients treated during pregnancy and patients treated after delivery.
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Affiliation(s)
- Lei Yang
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China.,Guangdong Lung Cancer Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Yun-Ting He
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China.,Guangdong Lung Cancer Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Jin Kang
- Guangdong Lung Cancer Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Ming-Ying Zheng
- Guangdong Lung Cancer Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Zhi-Hong Chen
- Guangdong Lung Cancer Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Hong-Hong Yan
- Guangdong Lung Cancer Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Xu-Chao Zhang
- Guangdong Lung Cancer Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Jin-Ji Yang
- Guangdong Lung Cancer Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Yi-Long Wu
- Guangdong Lung Cancer Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Qing Zhou
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China.,Guangdong Lung Cancer Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
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3
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Silverstein J, Post AL, Chien AJ, Olin R, Tsai KK, Ngo Z, Van Loon K. Multidisciplinary Management of Cancer During Pregnancy. JCO Oncol Pract 2021; 16:545-557. [PMID: 32910882 DOI: 10.1200/op.20.00077] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Cancer during pregnancy is relatively rare but is increasing in frequency in countries in which the maternal child-bearing age continues to rise. The complexities of medical decision making are underscored by the need to weigh the potential benefits of any intervention for the mother against the risks to the fetus. A majority of diagnostic evaluations can be performed safely in the setting of pregnancy and should not be delayed. Noninvasive prenatal testing that shows discordance with fetal karyotype can be a clue to an underlying maternal malignancy. After diagnosis, a multidisciplinary team should formulate a care plan for both the mother and the fetus. Key topics for discussion should include the mother's prognosis, standard treatment plan, and predictions of how modifications for a continuing pregnancy will affect the treatment plan and overall prognosis. In the context of this knowledge, frank discussions about pregnancy termination should be addressed with the patient, if appropriate. Selection of a plan for oncologic management in the case of a pregnant woman is based on the type of cancer, the tumor biology, and the tumor stage. Additional complexities for pregnant patients are typically related to the gestational age of the fetus, the dynamic physiologic changes of pregnancy, and the limited safety data for administration of most anticancer therapies during pregnancy. In this article, we summarize data related to different classes of anticancer therapies as well as considerations for the management of selected cancers. Finally, we provide some key principles that should be considered in the management of patients with cancer during pregnancy.
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Affiliation(s)
- Jordyn Silverstein
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA
| | - Annalisa L Post
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA
| | - A Jo Chien
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA.,Division of Hematology and Oncology, Department of Medicine, University of California, San Francisco, San Francisco, CA
| | - Rebecca Olin
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA.,Division of Hematology and Oncology, Department of Medicine, University of California, San Francisco, San Francisco, CA
| | - Katy K Tsai
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA.,Division of Hematology and Oncology, Department of Medicine, University of California, San Francisco, San Francisco, CA
| | - Zoe Ngo
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA.,Department of Pharmacy, University of California, San Francisco, San Francisco, CA
| | - Katherine Van Loon
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA.,Division of Hematology and Oncology, Department of Medicine, University of California, San Francisco, San Francisco, CA
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Le Guevelou J, Lebars S, Kammerer E, de Gabory L, Vergez S, Janot F, Baujat B, Righini C, Jegoux F, Dufour X, Merol JC, Mauvais O, Lasne-Cardon A, Selleret L, Thariat J. Head and neck cancer during pregnancy. Head Neck 2019; 41:3719-3732. [PMID: 31329334 DOI: 10.1002/hed.25877] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 06/28/2019] [Accepted: 07/03/2019] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND The incidence of cancer during pregnancy is low but is slightly increasing. Data on incidence and etiology of head and neck (HN) cancers in pregnant women are rare. We evaluated the frequency, tumor type, associated factors, and specific biomarkers in HN cancers occurring in pregnant (and peripartum) women. METHODS A systematic literature search was performed on PubMed, for any HN tumor site occurring in pregnant women. RESULTS Sixty cases of HN cancers occurring during pregnancy were identified. Most of them were oral cavity cancers. Relationships with oncogenic viruses, hormonal disturbance, and shift in maternal immunity profile were identified. CONCLUSION Carcinogenesis of HN cancers in pregnant women may be led by different cancer type-specific hallmarks. Relevance of these etiological factors with respect to treatments and birth control recommendations is being investigated by the REFCOR in an ambispective study.
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Affiliation(s)
| | | | | | - Ludovic de Gabory
- Service de Chirurgie ORL, Centre Hospitalier Universitaire Pellegrin, Bordeaux, France
| | - Sebastien Vergez
- Service de Chirurgie ORL, Centre Hospitalier Universitaire Rangueil-Larrey, Toulouse, France
| | - François Janot
- Service de Chirurgie ORL, Centre Gustave Roussy, Villejuif, France
| | - Bertrand Baujat
- Service de Chirurgie ORL, Hopital Tenon, Université Paris-Est, Paris, France
| | - Christian Righini
- Service de Chirurgie ORL, Centre Hospitalier Universitaire de Grenoble, Grenoble, France
| | - Franck Jegoux
- Service de Chirurgie ORL, Centre Hospitalier Universitaire Pontchaillou, Rennes, France
| | - Xavier Dufour
- Service de Chirurgie ORL, Centre Hospitalier Universitaire de Poitiers, Poitiers, France
| | - Jean-Claude Merol
- Service de Chirurgie ORL, Centre Hospitalier Universitaire de Reims, Reims, France
| | - Olivier Mauvais
- Service de Chirurgie ORL, Centre Hospitalier Universitaire de Besançon, Besançon, France
| | - Audrey Lasne-Cardon
- Service de Chirurgie ORL Centre François Baclesse, Normandie Université-Unicaen, Caen, France
| | - Lise Selleret
- Service de Gynécologie Obstetrique, Hopital Tenon, Paris, France
| | - Juliette Thariat
- Service de Radiothérapie, Centre François Baclesse, Caen, France
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5
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6
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Dagogo-Jack I, Gainor JF, Porter RL, Schultz KR, Solomon BJ, Stevens S, Azzoli CG, Sequist LV, Lennes IT, Shaw AT. Clinicopathologic Features of NSCLC Diagnosed During Pregnancy or the Peripartum Period in the Era of Molecular Genotyping. J Thorac Oncol 2016; 11:1522-8. [PMID: 27296107 DOI: 10.1016/j.jtho.2016.05.031] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Revised: 05/18/2016] [Accepted: 05/20/2016] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Cancer will be diagnosed in one in 1000 women during pregnancy. The outcomes of NSCLC diagnosed during pregnancy are dismal, with most patients dying within 1 year. Actionable mutations are more likely to be found among younger patients with NSCLC. However, most previous reports of NSCLC diagnosed during pregnancy did not include molecular genotyping. METHODS We performed a retrospective analysis of patients seen at our institution between 2009 and 2015 to identify women in whom NSCLC was diagnosed during pregnancy or the peripartum period and determined clinicopathologic features, including molecular genotype. RESULTS We identified 2422 women with NSCLC, including 160 women of reproductive age. Among the women of reproductive age, eight cases of NSCLC diagnosed during pregnancy or the peripartum period were identified; all were diagnosed in minimal or never-smokers with metastatic adenocarcinoma. Six of these patients were found to have anaplastic lymphoma kinase gene (ALK) rearrangements, whereas the remaining two were EGFR mutation positive. We observed a borderline significant association between a diagnosis of NSCLC during pregnancy or the peripartum period and ALK positivity (p = 0.053). All eight women in whom NSCLC was diagnosed during pregnancy or the peripartum period received treatment with genotype-directed therapies after delivery. The median overall survival has not been reached at a median follow-up of 30 months. CONCLUSIONS Although a diagnosis of NSCLC during pregnancy or the peripartum period is rare, diagnostic evaluation should not be delayed in pregnant women presenting with symptoms worrisome for lung cancer. Evaluation should include testing for targetable molecular alterations.
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Affiliation(s)
- Ibiayi Dagogo-Jack
- Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Justin F Gainor
- Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Rebecca L Porter
- Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Katherine R Schultz
- Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Benjamin J Solomon
- Department of Medical Oncology, Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia
| | - Sara Stevens
- Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Christopher G Azzoli
- Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Lecia V Sequist
- Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Inga T Lennes
- Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Alice T Shaw
- Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
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7
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8
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Le cancer bronchique de la femme enceinte : prise en charge diagnostique et thérapeutique en 2012. Rev Mal Respir 2013; 30:125-36. [DOI: 10.1016/j.rmr.2012.11.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2012] [Accepted: 10/18/2012] [Indexed: 12/31/2022]
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9
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Selig BP, Furr JR, Huey RW, Moran C, Alluri VN, Medders GR, Mumm CD, Hallford HG, Mulvihill JJ. Cancer chemotherapeutic agents as human teratogens. ACTA ACUST UNITED AC 2012; 94:626-50. [DOI: 10.1002/bdra.23063] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2012] [Revised: 06/29/2012] [Accepted: 07/04/2012] [Indexed: 12/11/2022]
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10
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Azim HA, Peccatori FA, Pavlidis N. Lung cancer in the pregnant woman: To treat or not to treat, that is the question. Lung Cancer 2010; 67:251-6. [DOI: 10.1016/j.lungcan.2009.10.006] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2009] [Revised: 10/01/2009] [Accepted: 10/03/2009] [Indexed: 11/30/2022]
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11
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Thelmo MC, Shen EP, Shertukde S. Metastatic pulmonary adenocarcinoma to placenta and pleural fluid: clinicopathologic findings. Fetal Pediatr Pathol 2010; 29:45-56. [PMID: 20055563 DOI: 10.3109/15513810903266625] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
OBJECTIVES To report the clinicopathologic findings of a pregnant woman with Stage IV adenocarcinoma of the lung with placental metastasis. MATERIALS AND METHODS Medical records review. RESULTS A 31-year-old G(2)P(1001) woman was diagnosed with Stage IV metastatic adenocarcinoma of the lung. At 34 weeks' and 2 days' gestation, she went into preterm labor and delivered a live male infant, weighing 2595 grams, with Apgar scores of 9 and 9, respectively. Placental pathology was significant for adenocarcinoma with a solid and acinar pattern, consistent with that from the lung. Her postpartum course was uneventful. She did not receive chemotherapy and expired one month postpartum. To date, the infant is without evidence of disease. CONCLUSIONS The occurance of lung cancer in pregnancy is rare and a few cases have been reported in literature. Placental metastasis is extremely uncommon in these cases and can lead to fetal involvement by lung tumor. It is important to report all cases of lung cancer occurring in pregnancy with subsequent close clinical surveillance of the infant as all cases have a different clinical picture.
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Affiliation(s)
- Marylou C Thelmo
- Department of Obstetrics and Gynecology, Kern Medical Center-UCLA, Bakersfield, California 93305, USA
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12
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Azim HA, Peccatori FA, Pavlidis N. Treatment of the pregnant mother with cancer: a systematic review on the use of cytotoxic, endocrine, targeted agents and immunotherapy during pregnancy. Part I: Solid tumors. Cancer Treat Rev 2009; 36:101-9. [PMID: 20015593 DOI: 10.1016/j.ctrv.2009.11.007] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2009] [Revised: 11/05/2009] [Accepted: 11/15/2009] [Indexed: 01/14/2023]
Abstract
The association of cancer and pregnancy is increasingly encountered nowadays in clinical practice. Due to the relative rarity of the situation, it lacks a systematized approach. Different systemic therapies are used in managing cancer with uncertainty regarding the potential hazards they could pose on the pregnancy and/or the fetus. We have performed a systematic review of literature to identify all reports addressing cancer patients who were exposed to any of the known systemic therapies during the course of the pregnancy. The results were discussed in two parts; part I addresses pregnant patients with solid tumors while part I for those with hematological malignancies. In part I, we identified different solid tumors diagnosed and treated during the course of pregnancy. Breast cancer was the most commonly treated followed by ovarian cancer. Other tumors were treated as well including lung cancer, cervical cancer, sarcoma and melanomas. It is important to acknowledge the intent of therapy (palliative vs. curative) and the patients has to be properly counseled to reach an informed decision. We aim to provide a more robust consensus on how to approach these cases and provide a higher degree of evidence to support the safety of applying certain management strategies over the other.
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Affiliation(s)
- Hatem A Azim
- Department of Medical Oncology, National Cancer Institute, Cairo University, 55 Abdel Monem Riad Street, Mohandeseen, Cairo, Egypt.
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13
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Gurumurthy M, Koh P, Singh R, Bhide A, Satodia P, Hocking M, Anbarasu A, Wood LEP. Metastatic non-small-cell lung cancer and the use of gemcitabine during pregnancy. J Perinatol 2009; 29:63-5. [PMID: 19112460 DOI: 10.1038/jp.2008.128] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
We present a case of metastatic non-small-cell lung malignancy diagnosed in the mother in her 24th week of pregnancy and illustrate the obstetric, oncology, neonatal and ethical issues involved. This is the second reported case on the use of gemcitabine for lung cancer in human pregnancy.
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Affiliation(s)
- M Gurumurthy
- Department of Obstetrics and Gynaecology, Arden Cancer Centre and Neonatal Unit, University Hospital Coventry and Warwickshire, Coventry, UK.
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Mir O, Berveiller P, Ropert S, Goffinet F, Goldwasser F. Use of platinum derivatives during pregnancy. Cancer 2008; 113:3069-74. [DOI: 10.1002/cncr.23935] [Citation(s) in RCA: 96] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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15
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Grossesse et cancer du poumon : à propos d’un cas et revue de la littérature. ACTA ACUST UNITED AC 2008; 37:808-10. [DOI: 10.1016/j.jgyn.2008.05.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2007] [Revised: 05/26/2008] [Accepted: 05/28/2008] [Indexed: 11/15/2022]
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16
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García-González J, Cueva J, Lamas MJ, Curiel T, Graña B, López-López R. Paclitaxel and cisplatin in the treatment of metastatic non-small-cell lung cancer during pregnancy. Clin Transl Oncol 2008; 10:375-6. [DOI: 10.1007/s12094-008-0215-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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17
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Successful treatment of small cell lung cancer during pregnancy. Lung Cancer 2008; 61:129-30. [DOI: 10.1016/j.lungcan.2007.10.007] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2007] [Accepted: 10/06/2007] [Indexed: 01/29/2023]
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18
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Zambelli A, Prada GAD, Fregoni V, Ponchio L, Sagrada P, Pavesi L. Erlotinib administration for advanced non-small cell lung cancer during the first 2 months of unrecognized pregnancy. Lung Cancer 2008; 60:455-7. [DOI: 10.1016/j.lungcan.2007.10.025] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2007] [Revised: 10/23/2007] [Accepted: 10/26/2007] [Indexed: 11/25/2022]
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19
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Prolonged survival of a woman with lung cancer diagnosed and treated with chemotherapy during pregnancy. Lung Cancer 2008; 60:285-90. [DOI: 10.1016/j.lungcan.2007.09.019] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2007] [Revised: 09/03/2007] [Accepted: 09/21/2007] [Indexed: 12/14/2022]
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20
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Mir O, Berveiller P, Ropert S, Goffinet F, Pons G, Treluyer JM, Goldwasser F. Emerging therapeutic options for breast cancer chemotherapy during pregnancy. Ann Oncol 2008; 19:607-13. [DOI: 10.1093/annonc/mdm460] [Citation(s) in RCA: 96] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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21
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Kim JH, Kim HS, Sung CW, Kim KJ, Kim CH, Lee KY. Docetaxel, gemcitabine, and cisplatin administered for non-small cell lung cancer during the first and second trimester of an unrecognized pregnancy. Lung Cancer 2008; 59:270-3. [PMID: 17688967 DOI: 10.1016/j.lungcan.2007.06.017] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2007] [Revised: 06/24/2007] [Accepted: 06/27/2007] [Indexed: 11/17/2022]
Abstract
Although several chemotherapeutic agents have been proven to be safe for the fetus after the organogenesis period, there is limited information on their use during the first trimester of pregnancy. We here report the first case of a patient with lung cancer who was treated with platinum-based chemotherapy from the first trimester of an unrecognized pregnancy. A 35-year-old woman was diagnosed with stage IV non-small cell lung cancer with brain metastasis. Since she recalled the date of her last menstrual period at about 20 days prior to consult, we did not consider the possibility of conception at the time of diagnosis. With an object of controlling the increased intracranial pressure, we initially performed a craniotomy with tumor removal, followed by whole brain irradiation. Without our knowledge of her pregnancy, she received a palliative chemotherapy with docetaxel and cisplatin followed by gemcitabine and cisplatin as the second-line chemotherapeutic agents between weeks 9 and 22 of gestation. Follow-up computed tomographic scans performed 2 months after the last chemotherapy showed a fetus in the patient's abdomen. Cesarean section was performed at 33 weeks of gestation, delivering a 1490 g female newborn with no evidence of congenital malformations.
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MESH Headings
- Adult
- Antineoplastic Agents/therapeutic use
- Brain Neoplasms/diagnostic imaging
- Brain Neoplasms/secondary
- Brain Neoplasms/therapy
- Carcinoma, Non-Small-Cell Lung/diagnosis
- Carcinoma, Non-Small-Cell Lung/drug therapy
- Cisplatin/therapeutic use
- Deoxycytidine/analogs & derivatives
- Deoxycytidine/therapeutic use
- Diagnosis, Differential
- Docetaxel
- Drug Therapy, Combination
- Female
- Follow-Up Studies
- Humans
- Immunosuppressive Agents/therapeutic use
- Infant, Newborn
- Lung Neoplasms/diagnostic imaging
- Lung Neoplasms/drug therapy
- Lung Neoplasms/pathology
- Neoplasm Staging
- Pregnancy
- Pregnancy Complications, Neoplastic/diagnosis
- Pregnancy Complications, Neoplastic/therapy
- Pregnancy Outcome
- Pregnancy Trimester, First
- Pregnancy Trimester, Second
- Radiation-Sensitizing Agents
- Ribonucleotide Reductases/antagonists & inhibitors
- Taxoids/therapeutic use
- Tomography, X-Ray Computed
- Gemcitabine
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Affiliation(s)
- Jung Han Kim
- Division of Hematology and Oncology, Department of Internal Medicine, Hallym University College of Medicine, Seoul, Republic of Korea.
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Pentheroudakis G, Pavlidis N. Gastrointestinal, urologic and lung malignancies during pregnancy. Recent Results Cancer Res 2008; 178:137-164. [PMID: 18080450 DOI: 10.1007/978-3-540-71274-9_13] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Affiliation(s)
- G Pentheroudakis
- Department of Medical Oncology, Ioannina University Hospital, Greece
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Mazières J, Rouquette I, Brouchet L. Cancer bronchique de la femme et de la femme enceinte : vers une origine hormonale ? Rev Mal Respir 2007; 24:983-97. [DOI: 10.1016/s0761-8425(07)92763-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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24
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Gonçalves Marcos IAC. [Pregnancy and lungs]. REVISTA PORTUGUESA DE PNEUMOLOGIA 2007; 13:213-37. [PMID: 17492234 DOI: 10.1016/s0873-2159(15)30345-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Respiratory pathology can be relatively frequent during pregnancy. One third of pregnant woman may experience worsening of their asthma condition. Pulmonary tromboembolism is 5 times more frequent in pregnancy. Bacterial, viral and fungal pneumonias are badly tolerated during pregnancy, provoking mother-foetal morbidity, respiratory insufficiency, low born-weight or prematurity. Non-treated tuberculosis may increase maternal mortality and preterm birth by 4 and 9 times respectively. Pregnancy is counter-indicated in women with cystic fibrosis and severe pulmonary function. Despite therapeutic progresses already made, pulmonary hypertension is associated to over 30% of mother-foetal morbidity and mortality. Approximately 1 in 1,000-1,500 pregnancies is affected by mother cancer. High rates of lung cancer morbility in women bring new and important challenges to therapy.
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25
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Burlacu CL, Fitzpatrick C, Carey M. Anaesthesia for caesarean section in a woman with lung cancer: case report and review. Int J Obstet Anesth 2007; 16:50-62. [PMID: 17125996 DOI: 10.1016/j.ijoa.2006.04.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2006] [Accepted: 06/01/2006] [Indexed: 10/23/2022]
Abstract
A 33-year-old woman pregnant with twins was diagnosed with metastatic lung cancer during pregnancy. Her multidisciplinary care raised many medical and ethical issues. To help decide on the best anaesthetic technique for caesarean section, a literature search of published case reports of pregnancy associated with lung cancer was performed. Thirty-five cases of primary lung cancer associated with pregnancy were found. Anaesthetic technique was reported in only five of the 20 patients who underwent caesarean section: one spinal, three epidurals and one general anaesthetic. Of the 11 patients who delivered vaginally, only one was reported to have received epidural analgesia. As published data regarding anaesthesia and analgesia are limited for women with lung cancer in pregnancy, we describe our perioperative approach and review the potential challenging aspects of management in a pregnant patient with metastatic lung cancer.
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Affiliation(s)
- C L Burlacu
- Department of Anaesthesia, Coombe Women's Hospital, Dublin, Ireland.
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26
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Ognio E, Chiavarina B, Peterka M, Mariggiò MA, Viale M. Study of feasibility of the treatment with procainamide hydrochloride and cisplatin in pregnant mice. Chem Biol Interact 2006; 164:232-40. [PMID: 17084828 DOI: 10.1016/j.cbi.2006.10.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2006] [Revised: 09/29/2006] [Accepted: 10/04/2006] [Indexed: 10/24/2022]
Abstract
Cisplatin is one of the most widely utilized anticancer drugs; nevertheless its use is often hampered by the onset of serious side effects. In spite of its tight binding to DNA, great teratogenic effects do not characterize cisplatin, although its embryolethal and growth retardation activities are quite remarkable. On the basis of our previous observations, demonstrating the usefulness of procainamide hydrochloride for the protection against cisplatin toxic effects in adult mice and rats, we now analyze the feasibility of the combined treatment with cisplatin and the antiarrhythmic drug procainamide hydrochloride in pregnant mice and the possible protective action of procainamide against the embryotoxic activity of cisplatin. Our data, obtained in CD-1 dams after treatment with 8 or 12 mg/kg cisplatin ip, with or without 50 mg/kg procainamide hydrochloride iv, confirm the embryotoxic effects of cisplatin. We also demonstrate that procainamide may be administered with cisplatin without causing an increase in its embryotoxic effects, but slightly improving some embryotoxicity parameters in living embryos such as the fetal weight, the percentage of fetuses with skeletal anomalies, and the number of ossification centres. The mechanism of action of this partially protective activity seems to be linked in part to the lower cisplatin accumulation in fetal tissue, probably due to an interaction of drugs at the level of placenta, in part to the protection of procainamide against maternal toxicity of cisplatin. A relevant result of this research is the suggestion that procainamide hydrochloride might be administered in case of pregnancy to protect against the maternal toxic effects of cisplatin without an increased embryotoxic/teratogenic risk for the offspring.
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Affiliation(s)
- Emanuela Ognio
- Istituto Nazionale per la Ricerca sul Cancro, SS Sperimentazioni su Modelli Animali, Lgo R Benzi, 10, 16132 Genova, Italy
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27
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Pentheroudakis G, Pavlidis N. Cancer and pregnancy: Poena magna, not anymore. Eur J Cancer 2006; 42:126-40. [PMID: 16326099 DOI: 10.1016/j.ejca.2005.10.014] [Citation(s) in RCA: 163] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2005] [Accepted: 10/06/2005] [Indexed: 01/02/2023]
Abstract
Cancer diagnosed during pregnancy constitutes a difficult clinical condition with a devastating impact on the patient's somatic and psychosocial health and possibly on foetal integrity. This circumstance also raises several moral, religious, social and familial dilemmas. In this review we critically present available evidence regarding the incidence, epidemiology and genetics of cancer in pregnant women, its presentation, diagnosis and staging as well as therapeutic management. Issues such as maternal/foetal prognosis, need for termination of pregnancy, risk of foetal health injury and necessity of psychosocial support are reviewed. Recent accumulating evidence suggests that, with appropriate management, poena magna should not be used to define neither cancer nor pregnancy.
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Affiliation(s)
- George Pentheroudakis
- Department of Medical Oncology, Ioannina University Hospital, University of Ioannina, 45 110 Ioannina, Greece
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28
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Fanale MA, Uyei AR, Theriault RL, Adam K, Thompson RA. Treatment of Metastatic Breast Cancer with Trastuzumab and Vinorelbine During Pregnancy. Clin Breast Cancer 2005; 6:354-6. [PMID: 16277887 DOI: 10.3816/cbc.2005.n.040] [Citation(s) in RCA: 72] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The management of breast cancer during pregnancy is a crucial clinical issue. It is important to evaluate the impact of chemotherapy on a woman and her fetus. Studies from our institution have demonstrated the safety and efficacy of treating women with adjuvant 5-fluorouracil/doxorubicin/cyclophosphamide during the second or third trimester of pregnancy. However, the literature regarding the treatment of metastatic breast cancer in a pregnant patient is scarce. In this article, we describe the successful treatment of a woman at 27 weeks of pregnancy with recurrent HER2/neu-overexpressing breast cancer who was symptomatic from multiple liver metastases. Per our review of the literature and to our knowledge, she is the first patient to be treated with weekly vinorelbine plus trastuzumab. Our patient had near complete resolution of her disease and delivered a healthy male infant at 34 weeks of gestation.
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Affiliation(s)
- Michelle A Fanale
- Department of Lymphoma and Myeloma, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77030, USA.
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29
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Jacobs IA, Chang C, Salti GI. Coexistence of Pregnancy and Cancer. Am Surg 2004. [DOI: 10.1177/000313480407001120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The purpose of this study was to review patients with cancer during pregnancy, the effectiveness of the available methods of treatment, and their prognosis. A retrospective chart review was conducted of all women diagnosed with pregnancy-associated cancer between 1974 and 2002 at the University of Illinois at Chicago Medical Center. The demographics, clinical presentation, time and mode of diagnosis, treatment, pregnancy outcome, and maternal survival were noted. The incidence of carcinoma in pregnancy in the series was 0.32/1000 deliveries. The age ranged from 16 to 41 years (mean 30.5 years). No patient underwent a therapeutic abortion, and all patients delivered a healthy infant with no malformations. Metastases developed in three patients with median time of 44 months (range 13–96 months) to presentation of metastases from the time of initial diagnosis. Association of cancer with pregnancy is a rare occurrence. Rates of specific cancers in pregnant and nonpregnant women appear to be equivalent. Pregnant women with cancer are often diagnosed at a later stage compared to their nonpregnant counterparts. Though the cancer may be diagnosed at a more advanced stage, pregnant patients with cancer do not appear to have a more aggressive clinical course.
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Affiliation(s)
- Ira A. Jacobs
- From the Department of Surgical Oncology, The University of Illinois at Chicago, Chicago, Illinois
| | - C.K. Chang
- From the Department of Surgical Oncology, The University of Illinois at Chicago, Chicago, Illinois
| | - George I. Salti
- From the Department of Surgical Oncology, The University of Illinois at Chicago, Chicago, Illinois
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30
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Teixeira E, Conde S, Alves P, Ferreira L, Figueiredo A, Parente B. A mulher e o cancro do pulmão**Textos referentes à mesa-redonda com o mesmo título organizada pela Comissão de Trabalho de «Pneumologia Oncológica». Coimbra, 13 de Abril de 2002. REVISTA PORTUGUESA DE PNEUMOLOGIA 2003; 9:225-47. [PMID: 14685633 DOI: 10.1016/s0873-2159(15)30670-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The epidemiology of lung cancer has changed in the last years in several countries all over the world. In the 19th century, the lung cancer was rare but it incidence increase drastically during the 20th century, and the tendency is to continue in the 20th century. Actually the lung cancer's incidence and mortality are higher in the developed countries, especially in Europe and Unites States of America, with a increasing in the women incidence. These geographic differences and gender differences are related with smoking habits. Women begin to smoke earlier and have more difficulty to stop, because of problems related with obesity; they have more sensibility to the carcinogens and the risk of lung cancer is 1.5 times higher than the men with the same habits. Adenocarcinoma is the more frequent histological type in young people, in the total of the women and in non-smokers. Many factors since tobacco, home and professional pollution, nutritional, associated diseases even genetic and hormonal factors have been investigated to define its influence in development in women lung cancer. It specificity in women with lung cancer is the common problem for the medical people to treat this disease (pathology).The literature about this problem is not clear, and is necessary to advance with many studies in this area with the objective to clarify this important question.
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Abstract
Pregnancy complicated by lung cancer has been rarely reported. The regional incidence of this complex situation is likely to increase in the future and optimal management needs to be established to better deal with this situation. We report two patients with metastatic lung cancer complicating pregnancy to highlight the evaluation and management difficulties associated with this problem and to contribute to the limited information in the literature.
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Affiliation(s)
- Catherine Mee-ming Wong
- Department of Medicine, Faculty of Medicine, University of Malaya Medical Centre, Kuala Lumpur, Malaysia.
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Abstract
Carcinoma of the lung continues to be the leading cause of cancer-related deaths for Americans. Major efforts have been made in the treatment of advanced non-small cell lung cancer; chemotherapy and investigations in the last decade have yielded a number of new agents and combinations. Despite progress with newer agents for the treatment of non-small cell lung cancer, only 14% of patients with the disease are alive 5 years after the initial diagnosis. Toward improving the outcome of patients with advanced non-small cell lung cancer, a few trends can be identified. These include further work on combination chemotherapy, the introduction of novel biologic agents into treatment, and predicting which patients will respond to chemotherapy. These trends are discussed in this review.
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Affiliation(s)
- Eric B Haura
- Thoracic Oncology Program and Clinical Investigations Program, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida 33612, USA.
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