A CASE OF POSTOPERATIVE RECURRENCE OF JUVENILE LUNG CANCER SUCCESSFULLY TREATED WITH ANAPLASTIC LYMPHOMA KINASE-TYROSINE KINASE INHIBITOR SEQUENTIAL THERAPY
Hiroshi Hashimoto*, Kazuyuki Komori, Shinichi Taguchi and Yuichi Ozeki
ABSTRACT
Anaplastic lymphoma kinase (ALK)-tyrosine kinase inhibitors (TKIs) have been approved for the treatment of postoperative recurrence of non-small cell lung cancer (NSCLC) caused by ALK rearrangement. A 38-year-old man underwent left upper lobectomy with mediastinal lymph node dissection for lung cancer (pT2aN2M0, stage IIIA). A gene mutation analysis showed negative epidermal growth factor receptor mutations and an ALK-positive translocation (fluorescence in situ hybridization-positive, ALK iScore 3 by iAEP immunohistochemistry). Crizotinib was administered postoperatively. Seventeen months later, computed tomography and positron emission tomography revealed paratracheal lymph node metastases. Crizotinib was discontinued, and treatment with a second-generation ALK-TKI, alectinib, was begun. Two months later, a partial response was achieved. No severe adverse events were observed. We continued the treatment with alectinib for more than 48 months, and a near-complete response was achieved. This patient’s management suggests that ALK-TKI sequential therapy (crizotinib to alectinib) may be safe and effective in ALK-positive NSCLC.
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