CONTEMPORARY TREATMENT OF ALK POSITIVE NON SMALL CELL LUNG CANCER PATIENT WITH BRAIN METASTASES: OUR EXPERIENCE

Popova M,S Crvenkova

doi:10.32553/ijmbs.v4i1.835

Abstract

Purpose: The aim of this study is to show alectinib efficacy and safety, with focus on alectinib intracranial efficacy. Case presentation: We report on a 46-year-old woman diagnosed as non small cell lung cancer harboring echinoderm microtubule-associated protein-like 4-anaplastic lymphoma kinase fusion gene. She has intracranial metastases and poor performance status of 3. We treated this patients with alectinib after whole brain irradiation and discontinuation of chemotherapy after two 2 cycles due to progressive brain and liver metastases. Good response was obtained with improving of her performance status without adverse events.  Conclusions: We recommend alectinib as a treatment approach for ALK+ NSCLC patients, especially those with CNS metastases at the time of the diagnosis and poor PS. Key words: CNS metastasis, ALK+ NSCLC patients, alectinib

Highlights

IntroductionDistinctive chromosomal rearrangements in the ALK gene (ALK-positive) were first described in 2007 and occur in approximately 2%–5% of patients with nsclc [2,3]
She has intracranial metastases and poor performance status of 3. We treated this patients with alectinib after whole brain irradiation and discontinuation of chemotherapy after two 2 cycles due to progressive brain and liver metastases
NSCLC represents over 80% of all lung cancers and 60% to 70% of the patients with NSCLC suffer from stage III or IV disease

Summary

Introduction

Distinctive chromosomal rearrangements in the ALK gene (ALK-positive) were first described in 2007 and occur in approximately 2%–5% of patients with nsclc [2,3]. Incidence of brain metastases (BMs) is higher in patients with ALK-positive NSCLC and among those patients up to 50-60% will develop BMs during the course of their disease [8]. After 9 months, CT and MRI showed lung and brain disappearance and substantial tumor regression in liver (Fig.1, 2, 3) The patient continues to be treated with alectinib without critical adverse events. Figure: Computed tomography scans depicting the tumor response at the inferior left lung lobe, 9 months after alectinib treatment (A pretreatment lung foci, B positive response to the alectinib after 9 months)

Discussion

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Conclusion