Case Report: Pregnant ROS1+ Lung Cancer Patient Treated with Crizotinib: Impact on Infancy

Theresa Weber^1,2*Jörg Hoffmann^1,2Christian Michel^1,2Andreas Burchert^1,2Jelena Pesek^2,3R. Verena Taudte^2,3Katharina Schoner^2,4Hilda Bartos^2,5Simon Viniol^2,5Paul Weiland^1,2Andreas Neubauer^1,2Sabine Flommersfeld^2,6Siegmund Köhler^2,7Mirjam Jung^2,8Stefanie Weber^2,8Svenja Foth^2,8Ines Wallot^2,8*

• ¹Department of Hematology, Oncology, and Immunology, University Hospital Giessen and Marburg, Campus Marburg, Marburg, Germany
• ²Philipps University Marburg, Marburg, Germany
• ³Core Facility for Metabolomics, Department of Medicine, Marburg, Germany
• ⁴Institute of Pathology, Fetal Pathology, University Hospital Giessen and Marburg, Campus Marburg, Marburg, Germany
• ⁵Clinic of Diagnostic and Interventional Radiology, University Hospital Giessen and Marburg, Campus Marburg, Marburg, Germany
• ⁶Center for Transfusion Medicine and Hemotherapy, University Hospital Giessen and Marburg, Campus Marburg, Marburg, Germany
• ⁷Department of Gynecology, Prenatal Medicine and Fetal Therapy, University Hospital Giessen and Marburg, Campus Marburg, Marburg, Germany
• ⁸Department of Pediatrics, University Hospital Giessen and Marburg, Campus Marburg, Marburg, Germany

Lung cancer remains the leading cause of cancer-related deaths worldwide. Managing cancer treatment during pregnancy is a rare yet challenging condition, with limited data available on maternal and neonatal outcomes. We present the case of a 37-year-old pregnant woman diagnosed with ROS-1-rearranged metastatic NSCLC, who was treated with crizotinib and subsequently delivered a preterm infant. Our report underscores the critical need for rigorous thromboembolic monitoring in pregnant patients undergoing cancer treatment. Furthermore, we provide evidence that placental tissue significantly reduces fetal crizotinib exposure, suggesting that crizotinib might be a viable therapeutic option for maintaining a pregnancy during lung cancer treatment.