Major pathologic response to alectinib in ALK-rearranged adenocarcinoma of the lung
Abstract Background Alectinib is a highly selective tyrosine kinase inhibitor of anaplastic lymphoma kinase (ALK) and provided a significantly prolonged progression-free survival compared with chemotherapy in patients with advanced non-small cell lung cancer (NSCLC) harboring rearrangements of the A...
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| Format: | Article |
| Language: | English |
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Japan Surgical Society
2018-03-01
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| Series: | Surgical Case Reports |
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| Online Access: | http://link.springer.com/article/10.1186/s40792-018-0430-7 |
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| author | Naoko Imanishi Kazue Yoneda Akihiro Taira Yoshinobu Ichiki Naoko Sato Masanori Hisaoka Fumihiro Tanaka |
| author_facet | Naoko Imanishi Kazue Yoneda Akihiro Taira Yoshinobu Ichiki Naoko Sato Masanori Hisaoka Fumihiro Tanaka |
| author_sort | Naoko Imanishi |
| collection | DOAJ |
| description | Abstract Background Alectinib is a highly selective tyrosine kinase inhibitor of anaplastic lymphoma kinase (ALK) and provided a significantly prolonged progression-free survival compared with chemotherapy in patients with advanced non-small cell lung cancer (NSCLC) harboring rearrangements of the ALK gene. Here, we present the first surgical case of ALK-rearranged lung adenocarcinoma with major pathological response in resected specimens after treatment with alectinib. Case presentation A 65-year-old female with clinical stage IIIA-N2 ALK-rearranged adenocarcinoma originating from the left lower lobe presented. Involvement of lower para-tracheal node was pathologically confirmed by endobronchial ultrasound-guided biopsy. Alectinib was prescribed, as the patient may not tolerate radiotherapy due to a mental illness. After 3 months’ treatment with alectinib, a remarkable radiological and metabolic response was achieved. The patient did not tolerate further continuation of alectinib treatment, and surgery was performed without any morbidity. Only < 10% tumor cells were viable in all resected specimens, indicating major pathological response to alectinib. Conclusions Salvage surgery after alectinib treatment may be safe and effective for initially unresectable NSCLC harboring ALK-rearrangements. |
| format | Article |
| id | doaj-art-acf10176d3dc4ce7bb6035007aea9be2 |
| institution | DOAJ |
| issn | 2198-7793 |
| language | English |
| publishDate | 2018-03-01 |
| publisher | Japan Surgical Society |
| record_format | Article |
| series | Surgical Case Reports |
| spelling | doaj-art-acf10176d3dc4ce7bb6035007aea9be22025-08-20T03:20:27ZengJapan Surgical SocietySurgical Case Reports2198-77932018-03-01411410.1186/s40792-018-0430-7Major pathologic response to alectinib in ALK-rearranged adenocarcinoma of the lungNaoko Imanishi0Kazue Yoneda1Akihiro Taira2Yoshinobu Ichiki3Naoko Sato4Masanori Hisaoka5Fumihiro Tanaka6Second Department of Surgery (Chest Surgery), University of Occupational and Environmental Health JapanSecond Department of Surgery (Chest Surgery), University of Occupational and Environmental Health JapanSecond Department of Surgery (Chest Surgery), University of Occupational and Environmental Health JapanSecond Department of Surgery (Chest Surgery), University of Occupational and Environmental Health JapanDepartment of Pathology, School of Medicine, University of Occupational and Environmental Health JapanDepartment of Pathology and Oncology, School of Medicine, University of Occupational and Environmental Health JapanSecond Department of Surgery (Chest Surgery), University of Occupational and Environmental Health JapanAbstract Background Alectinib is a highly selective tyrosine kinase inhibitor of anaplastic lymphoma kinase (ALK) and provided a significantly prolonged progression-free survival compared with chemotherapy in patients with advanced non-small cell lung cancer (NSCLC) harboring rearrangements of the ALK gene. Here, we present the first surgical case of ALK-rearranged lung adenocarcinoma with major pathological response in resected specimens after treatment with alectinib. Case presentation A 65-year-old female with clinical stage IIIA-N2 ALK-rearranged adenocarcinoma originating from the left lower lobe presented. Involvement of lower para-tracheal node was pathologically confirmed by endobronchial ultrasound-guided biopsy. Alectinib was prescribed, as the patient may not tolerate radiotherapy due to a mental illness. After 3 months’ treatment with alectinib, a remarkable radiological and metabolic response was achieved. The patient did not tolerate further continuation of alectinib treatment, and surgery was performed without any morbidity. Only < 10% tumor cells were viable in all resected specimens, indicating major pathological response to alectinib. Conclusions Salvage surgery after alectinib treatment may be safe and effective for initially unresectable NSCLC harboring ALK-rearrangements.http://link.springer.com/article/10.1186/s40792-018-0430-7ALKAlectinibPathologic responseAdenocarcinomaLung |
| spellingShingle | Naoko Imanishi Kazue Yoneda Akihiro Taira Yoshinobu Ichiki Naoko Sato Masanori Hisaoka Fumihiro Tanaka Major pathologic response to alectinib in ALK-rearranged adenocarcinoma of the lung Surgical Case Reports ALK Alectinib Pathologic response Adenocarcinoma Lung |
| title | Major pathologic response to alectinib in ALK-rearranged adenocarcinoma of the lung |
| title_full | Major pathologic response to alectinib in ALK-rearranged adenocarcinoma of the lung |
| title_fullStr | Major pathologic response to alectinib in ALK-rearranged adenocarcinoma of the lung |
| title_full_unstemmed | Major pathologic response to alectinib in ALK-rearranged adenocarcinoma of the lung |
| title_short | Major pathologic response to alectinib in ALK-rearranged adenocarcinoma of the lung |
| title_sort | major pathologic response to alectinib in alk rearranged adenocarcinoma of the lung |
| topic | ALK Alectinib Pathologic response Adenocarcinoma Lung |
| url | http://link.springer.com/article/10.1186/s40792-018-0430-7 |
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