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Case Series
Two young women diagnosed with metastatic, KRAS G12D-mutant lung adenocarcinoma during pregnancy
1 MRCP, Medical Registrar, Department of Obstetric Medicine, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
2 MRCP, Locum Consultant Obstetric Physician, Department of Obstetric Medicine, Guy’s and St Thomas’ NHS Foundation Trust, UK; Department of Women and Children’s Health, King’s College, London, UK
3 MRCOG PhD, Obstetric Registrar, Department of Obstetrics, Lewisham and Greenwich NHS Foundation Trust, London, UK
4 FRCP, Professor of Obstetric Medicine and Consultant Obstetric Physician, Department of Obstetric Medicine, Guy’s and St Thomas’ NHS Foundation Trust, UK; Department of Women and Children’s Health, King’s College, London, UK
5 MRCP PhD, Consultant Medical Oncologist, Department of Medical Oncology, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
Address correspondence to:
Catherine Nelson-Piercy
Obstetric Medicine Department, St Thomas’ Hospital, SE1 7EH, London,
UK
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Article ID: 100145Z10HG2025
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Gerretsen H, Nana M, Nathan HL, Nelson-Piercy C, Gennatas S. Two young women diagnosed with metastatic, KRAS G12D-mutant lung adenocarcinoma during pregnancy. J Case Rep Images Oncology 2025;11(1):25–32.ABSTRACT
Introduction: Cancer diagnosis during pregnancy is rare, but the incidence is expected to rise. Lung cancer during pregnancy is often diagnosed at an advanced stage, with overall poor prognosis. Symptoms are often attributed to alternative diagnoses or physiological changes of pregnancy. Diagnostic imaging is also sometimes delayed due to concerns regarding the hazardous effects of radiation exposure on the fetus.
Case Series: We present two cases of patients diagnosed with metastatic lung adenocarcinoma during pregnancy. Neither patient had a targetable mutation for treatment, but were found to have KRAS G12D-mutation. Both patients were started on carboplatin, pemetrexed, and pembrolizumab after delivery of their babies. They both died a few months post-diagnosis.
Conclusion: Evidence regarding management of lung cancer in pregnancy is limited, based on case reports and no randomized control trials. This case series highlights the importance of clinicians having a low threshold to investigate for cancer in pregnancy, to aid earlier diagnosis and improve prognosis.
Keywords: KRAS mutant, Lung adenocarcinoma, Metastatic, Pregnancy
SUPPORTING INFORMATION
Acknowledgments
We thank Dr. Eiichi Konishi for the histopathological review.
Author ContributionsHannah Gerretsen - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Melanie Nana - Substantial contributions to conception and design, Interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Hannah L Nathan - Acquisition of data, Analysis of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Catherine Nelson-Piercy - Acquisition of data, Analysis of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guaranter of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2025 Hannah Gerretsen et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
