Cleveland teacher Maralee Lellio gave birth to her second daughter in July 2024 after being treated for Stage IV breast cancer that had spread to her brain. Lellio became pregnant without in vitro fertilization following treatment at the Cleveland Clinic that included radiation and a PARP inhibitor.

Lellio was first diagnosed with Stage II breast cancer at age 29. Her oncologist recommended chemotherapy and surgery, and she underwent chemotherapy and a double mastectomy. Before beginning chemotherapy, Lellio and her husband froze embryos. She was declared cancer-free in September 2019, and the couple started in vitro fertilization.

In summer 2020, Lellio began experiencing headaches and dizziness. A CT scan did not show any abnormalities. During a telehealth appointment, a doctor recommended she go to the emergency room, where an MRI revealed a large brain tumor. Her breast cancer had recurred as Stage IV and spread to her brain. According to the National Breast Cancer Foundation, about one in three patients with Stage IV breast cancer survive more than five years. The disease is considered incurable.

Lellio underwent a craniotomy, but the tumor grew back larger than before. Her original oncologist recommended she transfer her care to the Cleveland Clinic, where she began radiation therapy. The treatment caused seizures and left her unable to walk.

"I just accepted that I was dying and I wasn't going to get to see my daughter grow up, I wasn't going to ever get to have the second baby I'd always dreamed of, and that was it. That I could only hope for a couple of good years before I inevitably died," Lellio said. "I understand that this is a very bad diagnosis, but I believe I'm going to live," she also said. A supporter later told her: "Maralee, it really makes me sad when you tell people and when you accept that you only have a couple of years left, because I think that you could survive this. We've seen stories of other people doing it. We know that it can happen, that there are unicorns out there, and I think that could be you."

"It was like somebody flipped a light switch on in my brain. So it was at that point I decided, 'I have to at least try,'" Lellio said.

In spring 2021, her Cleveland Clinic oncologist retired, and her care was transferred to Dr. Halle Moore. Scans showed that radiation had shrunk the brain tumor to almost nothing. Lellio's cancer tested positive for a BRCA-1 mutation, and Moore prescribed a PARP inhibitor, a treatment for cancers with genetic mutations. Moore supported Lellio's desire to have another child without argument. According to Moore, Lellio showed no evidence of active cancer while on the PARP inhibitor for two years. Moore agreed that Lellio could discontinue the medication after counseling and a one-year waiting period to attempt pregnancy.

Lellio continues to see Moore for frequent scans and is scheduled to receive a hysterectomy in the near future to limit the chance of another cancer occurring. She has returned to work as a teacher. "Cancer doesn't always read the textbooks, and a person with a dire prognosis can end up doing extraordinarily well, especially as innovative treatments are developed," Moore said.