Improvement of Crizotinib-resistant Leptomeningeal Carcinomatosis by Switching to Alectinib in a Case of Non-small Cell Lung Cancer Anaplastic Lymphoma Kinase (ALK) Translocation

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  • Komatsu Masamichi
    First Department of Internal Medicine, Shinshu University School of Medicine
  • Tateishi Kazunari
    First Department of Internal Medicine, Shinshu University School of Medicine
  • Kato Akane
    First Department of Internal Medicine, Shinshu University School of Medicine
  • Kobayashi Nobumitsu
    First Department of Internal Medicine, Shinshu University School of Medicine
  • Hanaoka Masayuki
    First Department of Internal Medicine, Shinshu University School of Medicine
  • Yomo Shoji
    Division of Radiation Oncology, Aizawa Comprehensive Cancer Center, Aizawa Hospital

Bibliographic Information

Other Title
  • クリゾチニブ耐性癌性髄膜炎に対してアレクチニブが奏効したALK遺伝子転座陽性非小細胞肺癌

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Description

Background. Leptomeningeal carcinomatosis is a devastating complication of non-small cell lung cancer (NSCLC). We herein report a case of crizotinib-resistant leptomeningeal carcinomatosis that improved after switching to alectinib. Case. A 47-year-old female was diagnosed as having anaplastic lymphoma kinase (ALK)-translocated NSCLC and treated with crizotinib. She underwent radiosurgery for multiple brain metastases at 7 and 13 months after the administration of crizotinib. Subsequently, symptoms of a visual disturbance, dysgeusia and nausea developed after 21 months of crizotinib treatment. Gadolinium-enhanced magnetic resonance imaging (MRI) revealed abnormal leptomeningeal enhancement. Her symptoms immediately improved after switching to alectinib. Although she required dose reduction due to drug-induced liver injury, MRI and a cerebrospinal fluid examination showed improved findings after 6 weeks of alectinib therapy. Conclusions. Alectinib treatment might be effective in the management of leptomeningeal carcinomatosis in cases of ALK-translocated NSCLC previously treated with crizotinib.

Journal

  • Haigan

    Haigan 55 (4), 223-227, 2015

    The Japan Lung Cancer Society

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