Treatment of lung cancer in pregnant women

Lung cancer in pregnancy is relatively rare, however, with increasing gestational age, its incidence is likely to increase. Many of the summary recommendations were developed before the advent of targeted therapies and immunotherapy, which represent a significant part of modern lung cancer treatment. The aim of this review is therefore to provide a current perspective on this issue.

In diagnostics, we are replacing PET/computed tomography with MRI. It is necessary to discuss with the patient sensitively whether to continue the pregnancy and if so, whether to choose treatment and what kind. Case reports are described about practically all treatment procedures generally known for lung cancer, but some of them cannot be recommended due to possible risks (bevacizumab, chest irradiation), other should be chosen with great caution (some targeted therapy, immunotherapy). Chemotherapy appears to be relatively safe outside the first trimester of pregnancy. The review also addresses general principles of neonatal delivery in these patients.

Lung cancer in pregnancy is highly stressful for both the pregnant woman and the treatment team. The benefits and risks of possible treatment options need to be openly discussed and a consensus reached between the patient and the treatment team.