Advances in Molecular Targeted Therapy May Expand the Scope of Fertility Preservation Counseling in Advanced Cancer: A Case in Which Brigatinib Achieved 5-Year Progression-Free Survival in a Patient with Stage IV ALKPositive Non-Small Cell Lung Cancer and a Live Birth Following Embryo Transfer After Discontinuation of Treatment

Megumi Yukimoto*, Yasushi Fukuda, Yu Tanaka, Tatsuki Kadomoto, Chisa Morisako, Shie Matsushima, Yasuko Ishihara, Ken Fukuhara and Tetsuro Honda

Department of Obstetrics and Gynecology, Kurashiki Central Hospital, Japan
Department of Respiratory Medicine, Kurashiki Central Hospital, Japan
Department of Obstetrics and Gynecology, Takamatsu Red Cross Hospital, Japan
Cancer Support Center, Kurashiki Central Hospital, Japan
Division of Pharmacy, Kurashiki Central Hospital, Japan

^*Correspondance to: Megumi Yukimoto 

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Abstract:

In Japan, Fertility Preservation (FP) counseling for cancer patients with poor prognoses appears to be
done infrequently because of prohibitions on posthumous reproduction and surrogacy. A 31-yearold
nulligravid woman diagnosed with Stage IV Anaplastic Lymphoma Kinase (ALK)-positive Non-
Small Cell Lung Cancer (NSCLC) with brain metastases. Following craniotomy for tumor resection,
embryo cryopreservation, and cranial radiotherapy, brigatinib (ALK inhibitor) was administered.
Five years of progression-free survival was observed. The patient requested Embryo Transfer (ET).
After a planned 7-month treatment interruption (washout period) and multidisciplinary counselling,
ET was performed. This resulted in a live birth at 37 weeks’ gestation with no tumor progression
during pregnancy. Brigatinib was resumed postpartum. To our knowledge, this is the first report
of a live birth following ET to herself during a planned interruption of molecular targeted therapy
in a patient with potential residual canner in advanced NSCLC. Advances in molecular targeted
therapies may expand the scope of FP counselling in patients traditionally considered to have poor
prognoses. However, ET performed in a patient with potential residual canner is not a standard
intervention. Determining the indication for such interventions requires a long-term observation of
this patient, further accumulation of clinical evidence, and rigorous ethical consideration.
 

Keywords:

Anaplastic Lymphoma Kinase (ALK); Fertility preservation; Molecular targeted
therapy; Non-Small Cell Lung Cancer (NSCLC); Pregnancy

Cite the Article:

Yukimoto M, Fukuda Y, Tanaka Y, Kadomoto T, Morisako C, Matsushima S, et al. Advances in Molecular Targeted Therapy May Expand the Scope of Fertility Preservation Counseling in Advanced Cancer: A Case in Which Brigatinib Achieved 5-Year Progression-Free Survival in a Patient with Stage IV ALK-Positive Non-Small Cell Lung Cancer and a Live Birth Following Embryo Transfer After Discontinuation of Treatment. Clin Case Rep Int. 2026; 10: 1761..