Researchers Share Insights From Lung Cancer and Pregnancy Registry

Lauren Kiel and Rebekah Kaufman, both undergraduate students working in the lab of Narjust Florez, MD, FASCO, at the Dana-Farber Cancer Institute, joined Lung Cancers Today at the IASLC 2024 World Conference on Lung Cancer to discuss their poster presentation on pregnancy and lung cancer.

The presentation outlined preliminary data from the Institutional Review Board (IRB)-approved Pregnancy and Lung Cancer Registry, which was launched by the Florez Lab in December 2023 as the first international registry to record cases of pregnancy and lung cancer.

“Our rationale for developing the registry was that a lot of our research within the Florez lab focuses on the clinical outcomes of young women and other understudied populations with lung cancer,” Kiel said.

It was important to begin gathering data on pregnancy and lung cancer because there is “such scarce data on it” and “there are no guidelines,” Kiel explained.

The topic of pregnancy and lung cancer has “peaked in relevance” due to the “increasing incidence of lung cancer in young patients,” Kaufman explained, with data showing that young women are now getting lung cancer more than young men. They explained the logistics of creating the registry and how data is collected.

“We created the Pregnancy and Lung Cancer Registry using RedCap and it’s an open survey for clinicians or patients themselves worldwide to enter data on pregnant patients who develop lung cancer or those who have lung cancer and become pregnant during treatment,” Kiel said.

The team invited clinicians and patients via email and social media outreach to enter cases of pregnant patients with lung cancer or patients diagnosed with lung cancer less than one year after delivery. They also entered retrospective cases from the Dana-Farber Cancer Institute and used descriptive statistics to summarize characteristics of the patients.

The team worked to make the form “very easily accessible” to reach clinicians and patients across the world, Kaufman explained.

“Having that international component was important because there is different access or different guidelines in different countries, so seeing what’s happening in different places was really important,” she said. “We do hope in the future for more of our global colleagues to input their cases as well.”

The data presented at the conference comprised 22 cases that have been analyzed so far, including 20 cases from the United States and 2 cases from Brazil.

“The vast majority were diagnosed with stage IV lung cancer and had an actionable biomarker,” Kiel said. “We thought this was important largely because it is consistent with literature on how younger patients are more likely to be diagnosed at an advanced stage, but they are more likely to have a targetable mutation. This makes it really important to elucidate the effects of targeted treatment—which is becoming more commonplace—on pregnancy and child outcomes.”

Kaufman noted that the Florez lab is working on a related project to understand how these targeted therapies impact fertility and that the registry data has provided initial insights on how lung cancer treatment types may vary across trimesters.

“Overall, we observed a nonuniformity in treatments utilized. In the first trimester, radiation was most common,” Kiel said. “And in the second and third trimesters, targeted therapy was the most common, followed by chemotherapy.”

The registry is also collecting data on maternal complications due to treatment during pregnancy, fetal complications, and infant outcomes, they explained. The maternal complications have included neutropenia and thrombocytopenia, with fetal complications including low birth weight and icterus. An early infant gestational age was reported in seven cases, five infants required placement in the neonatal intensive care unit after birth, and one infant required an operation.

“We’re hoping to gain more insight largely from the follow-up forms… to create empirical guidelines, guide treatment, and put more input into the literature,” Kiel said.

Overall, the data collected has shown that there is a lack of consensus surrounding the treatment of pregnant patients with lung cancer, Kiel and Kaufman said, noting that they are thankful for all who have participated and helped contribute to a growing understanding and awareness of co-occurring pregnancy and lung cancer.

“This is something that is growing and we’ll continue to develop for a long time in the future,” Kaufman said.

Clinicians who have a case to submit can email younglungresearch@dfci.harvard.edu to learn more and receive access to the form.