Narjust Florez: Ready for a Pregnancy and Lung Cancer Tweetorial?
Narjust Florez shared a post on her X/Twitter page:
“Ready for a Pregnancy and Lung Cancer Tweetorial?
1. Epidemiology
- The estimated incidence of cancer in pregnancy is about 1 in 1000.
- Increasing incidence of lung cancer in pregnancy due to advanced maternal age.
2. Characteristics
Most pregnant patients with lung cancer are more likely to:
- Median age at diagnosis of 35 years.
- Have had minimal or no prior tobacco use.
- Have adenocarcinoma histology.
- Present at an advanced stage due to diagnostic delays.
3. Biomarker Testing
- Genomic testing is ESSENTIAL, as actionable mutations are more likely to be found.
- Single-institution cohort study of patients with Stage IV Non-Small Cell Lung Cancer (NSCLC).
- 2422 female patients.
- 160 women of reproductive age (18-45 years).
4. Biomarker Testing continuation
- 8 pregnant patients; diagnosis made in all trimesters.
- All 8 pregnant patients had targetable molecular alteration: 6 with ALK translocation, 2 with sensitizing EGFR mutation, and were treated with targeted therapy post-delivery.
PMID: 27296107
5. Approach to Treatment
- No standardized approach for therapy for cancer in pregnancy.
- Important to weigh maternal benefits against potential fetal risks: most of the effects on fetus reported in first trimester.
- Many unanswered questions about the safety of Tyrosine Kinase Inhibitor (TKI) Therapy.
6. Survivorship and Management
- Multidisciplinary approach is important.
- While lung cancer diagnosis is relatively rare in pregnancy or peripartum, it is paramount to perform early evaluation of pregnant women with symptoms concerning for lung cancer.
- Molecular testing should be emphasized.
7. Need for Further Research
More research on pregnancy in lung cancer is required to help:
- Understand safety of targeted therapy.
- Develop standardized treatment regimens.
- Improve maternal and fetal outcomes.
- Early Diagnosis.
The Florez Lab created the first international registry for pregnancy and lung cancer to understand the disease in this special population. Anyone, anywhere can help by entering their own cases. To access the register email us to [email protected] or DM. ”
Source: Narjust Florez/X
Narjust Florez is the Associate Director of the Cancer Care Equity Program and a thoracic medical oncologist at the Dana-Farber Brigham Cancer Center. She is the principal investigator of the Sexual Health Assessment in Women with Lung Cancer (SHAWL) Study, the largest study to date evaluating sexual dysfunction in women with lung cancer. She received the 2020 Rising Star award by the LEAD National Conference for women in hematology and oncology. In addition, Dr. Florez founded the Florez Lab in 2019. The laboratory focuses on lung cancer, social justice issues in medicine, and medical education.
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