Thoracic Cancer (May 2022)

Successful treatment of refractory brain metastases from ALK‐positive lung cancer with lorlatinib

  • Yoshiko Nakagawa,
  • Tetsuo Shimizu,
  • Hisato Hiranuma,
  • Yasuhiro Gon

DOI
https://doi.org/10.1111/1759-7714.14406
Journal volume & issue
Vol. 13, no. 9
pp. 1431 – 1435

Abstract

Read online

Abstract A 44‐year‐old woman with ALK‐positive advanced adenocarcinoma of the lung was treated with crizotinib, and the lung lesions disappeared. The patient was treated with alectinib and chemotherapy, but brain metastases worsened; therefore, we performed an ALK resistance gene mutation test using plasma samples. Since no ALK resistance gene mutations were detected, we speculated that ALK inhibitors failed to achieve therapeutic effects due to poor transport to the central nervous system. Therefore, we switched to lorlatinib, and found a reduction in brain metastases. In ALK‐positive advanced lung cancer, plasma‐based resistance gene testing may be useful for treatment decisions.

Keywords