Delivery of a healthy baby after first-trimester maternal exposure to lapatinib.
We report the case of a woman who conceived while being treated on a phase I clinical trial with lapatinib, a dual inhibitor of epidermal growth factor receptor (EGFR) and HER2/neu, for metastatic breast cancer. Despite approximately 11 weeks of exposure to lapatinib in the first and second trimesters, the pregnancy was uncomplicated and resulted in the delivery of a healthy baby. Although concomitant cancer and pregnancy is relatively rare, the increasing use of biologic agents among fertile women, sometimes for as long as a year in the adjuvant setting increases the probability that some women will conceive while taking a growth factor pathway inhibitor. As with systemic chemotherapy given during pregnancy, there exists the potential for teratogenicity or fetal demise from exposure of the developing embryo to inhibitors of EGFR and HER2/neu. Despite the positive outcome of this case, continued caution is warranted with the use of EGFR and HER2/neu inhibitors in pregnancy.
Kelly
Hanna
H
Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
Graham
Mark
M
Humes
Elizabeth
E
Dorflinger
Laneta J
LJ
Boggess
Kim A
KA
O'Neil
Bert H
BH
Harris
Jennifer
J
Spector
Neil L
NL
Dees
E Claire
EC
D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy*; D018270:Carcinoma, Ductal, Breast / Q000188:drug therapy; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D000077341:Lapatinib; D050498:Live Birth; D009362:Neoplasm Metastasis / Q000188:drug therapy; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000188:drug therapy*; D011261:Pregnancy Trimester, First / Q000187:drug effects*; D011799:Quinazolines / Q000627:therapeutic use*
D000970:Antineoplastic Agents; D011799:Quinazolines; D000077341:Lapatinib