ALK-Positive Adenocarcinoma After Acquired Resistance to Lorlatinib and Transformation to SCLC: A Case Report

Huihui Li, BM; Tianqi Song, BM; Xiaoling Xu, MD

JTO Clinical and Research Reports (Feb 2023)

ALK-Positive Adenocarcinoma After Acquired Resistance to Lorlatinib and Transformation to SCLC: A Case Report

Huihui Li, BM,
Tianqi Song, BM,
Xiaoling Xu, MD

Affiliations

Huihui Li, BM: The Second Clinical Medical College of Wenzhou Medical University, Wenzhou, Zhejiang, People’s Republic of China; Zhejiang Key Laboratory of Diagnosis & Treatment Technology on Thoracic Oncology (Lung and Esophagus), The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, Zhejiang, People’s Republic of China
Tianqi Song, BM: The Second Clinical Medical College of Wenzhou Medical University, Wenzhou, Zhejiang, People’s Republic of China; Zhejiang Key Laboratory of Diagnosis & Treatment Technology on Thoracic Oncology (Lung and Esophagus), The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, Zhejiang, People’s Republic of China
Xiaoling Xu, MD: The Second Clinical Medical College of Wenzhou Medical University, Wenzhou, Zhejiang, People’s Republic of China; Zhejiang Key Laboratory of Diagnosis & Treatment Technology on Thoracic Oncology (Lung and Esophagus), The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, Zhejiang, People’s Republic of China; Corresponding author. Address for correspondence: Xiaoling Xu, MD, Zhejiang Key Laboratory of Diagnosis & Treatment Technology on Thoracic Oncology (Lung and Esophagus), The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, Zhejiang 310022, People’s Republic of China.

Journal volume & issue: Vol. 4, no. 2
p. 100464

Abstract

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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.

Published in JTO Clinical and Research Reports

ISSN: 2666-3643 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Internal medicine: Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Website: https://www.journals.elsevier.com/jto-clinical-and-research-reports/

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