A Case Report of Metastatic Gastric Cancer Treated with Pembrolizumab during Pregnancy.

IF 1.6 3区 医学 Q3 OBSTETRICS & GYNECOLOGY
Fetal Diagnosis and Therapy Pub Date : 2024-01-01 Epub Date: 2024-06-26 DOI:10.1159/000540000
Linda Piemonti, Laura Vettor, Elena Contro
{"title":"A Case Report of Metastatic Gastric Cancer Treated with Pembrolizumab during Pregnancy.","authors":"Linda Piemonti, Laura Vettor, Elena Contro","doi":"10.1159/000540000","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Immune checkpoint inhibitors are extensively used in present-day clinical practice for treating many types of cancers at different stages. To date, there are scarce data on the use of immunotherapy in pregnancy. Immune-related adverse events are a typical consequence of this therapy miming autoimmune diseases.</p><p><strong>Case presentation: </strong>A 35-year-old woman (G1P0) diagnosed with gastric carcinoma underwent neoadjuvant chemotherapy followed by surgery. During follow-up, axillary metastasis was discovered, radiotherapy failed, and consequently immunotherapy was started. Concurrently, pregnancy ensued. Despite potential risks, the patient opted to continue immunotherapy and the pregnancy. At 31 weeks, fetal bowel dilation was noted. Subsequently, the fetus also developed fetal growth restriction. A cesarean section was performed at 35 weeks. The newborn required repeated bowel resections for necrotizing enterocolitis, necessitating extensive medical intervention. The mother continues pembrolizumab treatment with a positive response.</p><p><strong>Conclusion: </strong>To the best of our knowledge, this might constitute a possible case of a fetal immune-related adverse event after immunotherapy in utero exposure.</p>","PeriodicalId":12189,"journal":{"name":"Fetal Diagnosis and Therapy","volume":" ","pages":"493-499"},"PeriodicalIF":1.6000,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11446398/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Fetal Diagnosis and Therapy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1159/000540000","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/6/26 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}
引用次数: 0

Abstract

Introduction: Immune checkpoint inhibitors are extensively used in present-day clinical practice for treating many types of cancers at different stages. To date, there are scarce data on the use of immunotherapy in pregnancy. Immune-related adverse events are a typical consequence of this therapy miming autoimmune diseases.

Case presentation: A 35-year-old woman (G1P0) diagnosed with gastric carcinoma underwent neoadjuvant chemotherapy followed by surgery. During follow-up, axillary metastasis was discovered, radiotherapy failed, and consequently immunotherapy was started. Concurrently, pregnancy ensued. Despite potential risks, the patient opted to continue immunotherapy and the pregnancy. At 31 weeks, fetal bowel dilation was noted. Subsequently, the fetus also developed fetal growth restriction. A cesarean section was performed at 35 weeks. The newborn required repeated bowel resections for necrotizing enterocolitis, necessitating extensive medical intervention. The mother continues pembrolizumab treatment with a positive response.

Conclusion: To the best of our knowledge, this might constitute a possible case of a fetal immune-related adverse event after immunotherapy in utero exposure.

一例在怀孕期间使用 pembrolizumab 治疗转移性胃癌的病例报告。
简介免疫检查点抑制剂(ICIs)在目前的临床实践中被广泛用于治疗处于不同阶段的多种癌症。迄今为止,有关妊娠期使用免疫疗法的数据还很少。免疫相关不良事件(irAE)是这种疗法模拟自身免疫性疾病的典型后果:一名 35 岁女性(G1P0)被诊断为胃癌,接受了新辅助化疗,随后进行了手术。随访期间发现腋窝转移,放疗失败,因此开始接受免疫治疗。与此同时,她也怀孕了。尽管存在潜在风险,患者还是选择继续接受免疫治疗并怀孕。怀孕 31 周时,发现胎儿肠管扩张。随后,胎儿也出现了胎儿生长受限(FGR)。患者在妊娠 35 周时进行了剖宫产手术(CS)。新生儿因坏死性小肠结肠炎(NEC)需要反复进行肠道切除,因此需要大量的医疗干预。母亲继续接受 pembrolizumab 治疗,反应良好:据我们所知,这可能是胎儿在宫内接触免疫疗法后发生免疫相关不良事件的一个病例。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Fetal Diagnosis and Therapy
Fetal Diagnosis and Therapy 医学-妇产科学
CiteScore
4.70
自引率
9.10%
发文量
48
审稿时长
6-12 weeks
期刊介绍: The first journal to focus on the fetus as a patient, ''Fetal Diagnosis and Therapy'' provides a wide range of biomedical specialists with a single source of reports encompassing the common discipline of fetal medicine.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信