JTO Clinical and Research Reports (Feb 2023)
ALK-Positive Adenocarcinoma After Acquired Resistance to Lorlatinib and Transformation to SCLC: A Case Report
Abstract
SCLC transformation is a phenomenon that is rarely described in ALK-rearranged cancers after treatment with ALK tyrosine kinase inhibitors, and it is exceedingly rare after lorlatinib use. We report the first case of a patient with an ALK-EML4 rearrangement who was resistant to lorlatinib simply due to transformation to SCLC and rapidly achieved partial response after traditional etoposide combined with cisplatin therapy. In addition, we provide a fishplot that visualizes tumor evolution on the basis of next-generation sequencing, which may predict small cell transformation and facilitate early treatment.