PMID- 24997732
OWN - NLM
STAT- MEDLINE
DCOM- 20150511
LR  - 20181202
IS  - 1872-8332 (Electronic)
IS  - 0169-5002 (Linking)
VI  - 85
IP  - 3
DP  - 2014 Sep
TI  - Efficacy and safety of gefitinib during pregnancy: case report and literature 
      review.
PG  - 481-4
LID - S0169-5002(14)00261-X [pii]
LID - 10.1016/j.lungcan.2014.06.003 [doi]
AB  - The incidence of lung cancer is rising in pregnancy, which is diagnosed on stage 
      III-IV in 98%. Almost half of these patients are non-smokers, who are associated 
      with more epidermal growth factor receptor (EGFR)-mutated lung cancer. As 
      cytotoxic chemotherapy is associated with poor outcome for mothers and 
      prematurity for children this will probably lead to repeatedly question the use 
      of EGFR-Tyrosine kinase inhibitors (TKI) (i.e. gefitinib and erlotinib) during 
      pregnancy for EGFR-mutated lung cancer. EGFR-TKIs are recommended as the first 
      line targeted therapy in case of advanced non small cell lung carcinoma (NSCLC) 
      with an activating EGFR mutation but not recommended during pregnancy due to lack 
      of data. We report clinical and pharmacological data for gefitinib during 
      pregnancy in both the mother and fetus and resume the literature on the subject. 
      A 33-year-old pregnant mother exhibited a disseminated EGFR-mutated lung 
      carcinoma with respiratory distress at 26 weeks of pregnancy. Gefitinib 
      administration was associated with rapid maternal respiratory improvement 
      allowing a planned cesarian section on week 35, giving birth to a healthy baby 
      (2575g) with regular development at 24 months of follow-up. The mother exhibited 
      a progression-free survival of 42 weeks with an overall survival of 22 months. 
      Gefitinib residual concentration was found in cord blood at 25.7ng/mL, confirming 
      a transplacental transfer, but at only 20% of the maternal concentration measured 
      at the same time (i.e. 127.1ng/mL). Gefitinib concentration in amniotic fluid, 
      which represents chronic fetal exposure to the drug, was also 20% of the maternal 
      residual concentration (16.9ng/mL) and reflected no fetal accumulation of the 
      drug, despite both long half time elimination of gefitinib (i.e. 48h) and long 
      time exposure (i.e. 55 days). This low transplacental transfer is an important 
      report, as potential side effect toxicity on the fetus is likely correlated to 
      gefitinib blood concentration.
CI  - Copyright (c) 2014 Elsevier Ireland Ltd. All rights reserved.
FAU - Gil, S
AU  - Gil S
AD  - Inserm, UMRS-1139, Paris, France; Universite Paris Descartes, Sorbonne Paris 
      Cite, Paris, France; PremUp Foundation, Paris, France.
FAU - Goetgheluck, J
AU  - Goetgheluck J
AD  - Service de gynecologie-obstetrique, hopital Foch, 40 rue Worth, Suresnes, France.
FAU - Paci, A
AU  - Paci A
AD  - Service de pharmacologie et d'analyse du medicament, Gustave Roussy, Villejuif, 
      France & Universite Paris-Sud, France.
FAU - Broutin, S
AU  - Broutin S
AD  - Service de pharmacologie et d'analyse du medicament, Gustave Roussy, Villejuif, 
      France & Universite Paris-Sud, France.
FAU - Friard, S
AU  - Friard S
AD  - Service de pneumologie, hopital Foch, 40 rue Worth, Suresnes, France.
FAU - Couderc, L J
AU  - Couderc LJ
AD  - Service de pneumologie, hopital Foch, 40 rue Worth, Suresnes, France; Faculte de 
      Medecine Paris-Ile de France-Ouest, Universite Versailles Saint Quentin en 
      Yvelines, France; UPRES EA220, Foch Hospital, University of Versailles 
      Saint-Quentin, Suresnes, France.
FAU - Ayoubi, J M
AU  - Ayoubi JM
AD  - Service de gynecologie-obstetrique, hopital Foch, 40 rue Worth, Suresnes, France.
FAU - Picone, O
AU  - Picone O
AD  - Service de gynecologie-obstetrique, hopital Foch, 40 rue Worth, Suresnes, France.
FAU - Tcherakian, C
AU  - Tcherakian C
AD  - Service de pneumologie, hopital Foch, 40 rue Worth, Suresnes, France; Faculte de 
      Medecine Paris-Ile de France-Ouest, Universite Versailles Saint Quentin en 
      Yvelines, France; UPRES EA220, Foch Hospital, University of Versailles 
      Saint-Quentin, Suresnes, France. Electronic address: 
      c.tcherakian@hopital-foch.org.
LA  - eng
PT  - Case Reports
PT  - Journal Article
PT  - Review
DEP - 20140616
PL  - Ireland
TA  - Lung Cancer
JT  - Lung cancer (Amsterdam, Netherlands)
JID - 8800805
RN  - 0 (Antineoplastic Agents)
RN  - 0 (Protein Kinase Inhibitors)
RN  - 0 (Quinazolines)
RN  - DA87705X9K (Erlotinib Hydrochloride)
RN  - EC 2.7.10.1 (ErbB Receptors)
SB  - IM
MH  - Adult
MH  - Antineoplastic Agents/administration & dosage/*adverse effects
MH  - Carcinoma, Non-Small-Cell Lung/diagnosis/drug therapy/genetics
MH  - ErbB Receptors/genetics
MH  - Erlotinib Hydrochloride
MH  - Fatal Outcome
MH  - Female
MH  - Humans
MH  - Lung Neoplasms/diagnosis/drug therapy/genetics
MH  - Mutation
MH  - Pregnancy
MH  - Pregnancy Complications, Neoplastic/diagnosis/drug therapy/genetics
MH  - Pregnancy Outcome
MH  - Protein Kinase Inhibitors/administration & dosage/*adverse effects
MH  - Quinazolines/administration & dosage/*adverse effects
MH  - Radiography, Thoracic
MH  - Tomography Scanners, X-Ray Computed
OTO - NOTNLM
OT  - EGFR-TKI
OT  - Epidermal growth factor receptor
OT  - Erlotinib
OT  - Gefitinib
OT  - Lung cancer
OT  - Pharmacology
OT  - Pregnancy
OT  - Tyrosine kinase inhibitors
EDAT- 2014/07/07 06:00
MHDA- 2015/05/12 06:00
CRDT- 2014/07/07 06:00
PHST- 2014/02/24 00:00 [received]
PHST- 2014/05/27 00:00 [revised]
PHST- 2014/06/08 00:00 [accepted]
PHST- 2014/07/07 06:00 [entrez]
PHST- 2014/07/07 06:00 [pubmed]
PHST- 2015/05/12 06:00 [medline]
AID - S0169-5002(14)00261-X [pii]
AID - 10.1016/j.lungcan.2014.06.003 [doi]
PST - ppublish
SO  - Lung Cancer. 2014 Sep;85(3):481-4. doi: 10.1016/j.lungcan.2014.06.003. Epub 2014 
      Jun 16.