Unplanned pregnancy in an HIV positive woman undergoing alectinib treatment for metastatic non-small-cell lung carcinoma

BMJ Case Rep. 2022 Jul 13;15(7):e247530. doi: 10.1136/bcr-2021-247530.

Abstract

We report an unplanned pregnancy in an HIV-positive woman in her 20s who was undergoing treatment for 6 months with alectinib (Alecensa) for stage IV non-small-cell lung carcinoma. Anaplastic lymphoma kinase (ALK)-tyrosine kinase inhibitor alectinib, a molecule that inhibits proteins involved in tumour cell growth, is the recommended first-line treatment option in case of ALK mutation. Although the patient was informed of the need for definitive contraception, she became pregnant during the treatment with alectinib. A complete tumour response was observed at the time the pregnancy was discovered. Treatment discontinuation was proposed as the patient wanted to keep the pregnancy. Alectinib was temporarily stopped throughout the remaining pregnancy period inline with the patient's wishes. The pregnancy was uncomplicated. She delivered a healthy female baby vaginally, with treatment being resumed after delivery. After 34 follow-up months, the patient remained in oncological remission and the child's physical development is normal.

Keywords: Cancer intervention; Drugs: obstetrics and gynaecology; HIV / AIDS; Lung cancer (oncology); Neonatal health.

Publication types

  • Case Reports

MeSH terms

  • Anaplastic Lymphoma Kinase
  • Carbazoles / therapeutic use
  • Carcinoma, Non-Small-Cell Lung* / pathology
  • Child
  • Female
  • HIV Infections*
  • Humans
  • Lung Neoplasms* / pathology
  • Piperidines
  • Pregnancy
  • Pregnancy, Unplanned
  • Protein Kinase Inhibitors / pharmacology
  • Protein Kinase Inhibitors / therapeutic use
  • Receptor Protein-Tyrosine Kinases / metabolism

Substances

  • Carbazoles
  • Piperidines
  • Protein Kinase Inhibitors
  • Anaplastic Lymphoma Kinase
  • Receptor Protein-Tyrosine Kinases
  • alectinib