A Case of ALK-positive Lung Cancer That Responded to Brigatinib Administered via Gastrostomy Using a Simple Suspension Method

Goto Hiroki, Yoshida Masamichi, Miki Hiroto, Masuda Kazuki, Kodama Shuji, Terashima Toshikazu, Fujiwara Atsushi

doi:10.2482/haigan.62.341

<p>Background. Tyrosine kinase inhibitors targeting the ALK domain (ALK-TKIs) play an important role in the treatment of ALK-positive lung cancer. However, it is difficult for patients who have dysphagia to benefit from ALK-TKIs, as ALK-TKIs are oral medications. Few data are available on the efficiency of a simple suspension method for and tube administration of ALK-TKIs. Case. A 71-year-old man was diagnosed with ALK-positive lung adenocarcinoma with multiple brain and lung metastases and left-sided malignant pleural effusion at our department in 2015. He was treated with crizotinib as the first-line treatment, but the tumors grew after 10 months. Thereafter he received alectinib as the second-line treatment, and the tumors remained controlled for four years and nine months. However, in February 2021, he experienced difficulty swallowing. His dysphagia gradually worsened, and in March 2021, he became unable to take anything but water orally. Upper gastrointestinal endoscopy and CT revealed that the paraesophageal lymph node metastasis had caused a stenosis to develop in the esophagus. He underwent gastric fistula placement and received brigatinib via gastrostomy. Thereafter, the esophageal stenosis was improved, and he was able to take food orally. Conclusion. We successfully administered brigatinib via gastrostomy using a simple suspension method in a case of ALK-positive lung cancer with esophageal stenosis.</p>

A Case of ALK-positive Lung Cancer That Responded to Brigatinib Administered via Gastrostomy Using a Simple Suspension Method

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