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A patient previously treated with ALK inhibitors for central nervous system lesions from ALK rearranged lung cancer: a case report

Authors Kashima J, Okuma Y, Hishima T

Received 15 May 2016

Accepted for publication 18 August 2016

Published 12 October 2016 Volume 2016:9 Pages 6059—6063


Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Ru Chen

Peer reviewer comments 4

Editor who approved publication: Dr Ingrid Espinoza

Jumpei Kashima,1 Yusuke Okuma,1,2 Tsunekazu Hishima3

1Department of Thoracic Oncology and Respiratory Medicine, Tokyo Metropolitan Cancer and Infectious diseases Center Komagome Hospital; 2Division of Oncology, Research Center for Medical Sciences, The Jikei University School of Medicine; 3Department of Pathology, Tokyo Metropolitan Cancer and Infectious diseases Center Komagome Hospital, Tokyo, Japan

Background: Patients with anaplastic lymphoma kinase (ALK)-rearranged non-small-cell lung cancer (NSCLC) are now preferentially treated with tyrosine kinase inhibitors (TKIs). However, patients treated with ALK inhibitors end up with acquired resistance.
Case presentation: We present a patient with recurrent ALK-rearranged NSCLC that developed multiple brain metastases and meningitis carcinomatosa after sequential treatment with several lines of cytotoxic chemotherapy, crizotinib, and alectinib. After the patient underwent retreatment with crizotinib as salvage therapy because of poor performance status, the intracranial metastatic foci and meningeal thickening were shrank within 1 week.
Conclusion: Our experience with this case suggests that alectinib may restore sensitivity to crizotinib or amplified pathway such as MET which bestowed alectinib resistance was inhibited with crizotinib.

Keywords: alectinib, anaplastic lymphoma kinase rearrangement, crizotinib

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