A Research Letter published July 9, 2015 in Online First JAMA Oncology features a case report by researchers at the University of Vermont Cancer Center that details the successful use of Erlotinib, the standard of care for certain non-small cell lung cancers, in pregnant patients. To date, chemotherapy has been recommended for pregnant patients with a certain type of lung cancer due to limited experience and uncertainty for fetus’ safety with Erlotinib – the standard of care in non-pregnant patients – but has yielded dismal outcomes, including death within one year of delivery.

The report, authored by Yongli Ji, M.D., Ph.D., and Claire Verschraegen, M.D., and colleagues, focuses on a successful clinical case where a female non-smoker diagnosed during pregnancy with Stage 4 non-small cell lung cancer was treated with Erlotinib. Now fourteen months post-partum, the baby is thriving and the mother has continued Erlotinib treatment, is in remission, and is working full time. Ji is a third-year oncology fellow at UVM.

Non-small cell lung cancer is a type of lung cancer where five-year survival rates are around 50 percent if caught early. In later stage diagnosis, the survival rate drops to below five percent. However, some non-small cell lung cancers that are linked to a specific genetic mutation have shown better response to the drug Erlotinib, thus making it the standard of care for those lung cancers. Lack of research around effects of this drug on pregnant women and fetuses has so far precluded pregnant women from accessing this treatment. This case report, which references eight known cases where the drug was used in pregnant women and showed promising results, makes a case for further research to confirm safety and outcomes for the use of Erlotinib in the treatment of pregnant women.

Physicians at the UVM Cancer Center, with expertise in treating pregnant women with cancer, feel confident that this individualized approach to care could be an option for pregnant patients to consider.

“I have experience and have published on treating cancer in pregnant women and had referenced previous cases as well,” says Verschraegen, deputy director of the UVM Cancer Center and senior author on the report. “It is always gratifying to be able to help someone.”

In addition to Li and Verschraegen, Julie Phillips, M.D., UVM assistant professor of obstetrics, gynecology and reproductive sciences, and researchers from Albany College of Pharmacy and Dartmouth-Hitchcock Medical Center contributed to this report.

Learn more about non-small cell lung cancer.