Alectinib re-challenge in small cell lung cancer transformation after chemotherapy failure in a patient with ALK-positive lung cancer: A case report

被引：18

作者：

Yamagata, Akira ^{[1
,2
]}

Yokoyama, Toshihide ^{[1
]}

Fukuda, Yasushi ^{[1
]}

Ishida, Tadashi ^{[1
]}

机构：

[1] Kurashiki Cent Hosp, Ohara Healthcare Fdn, Dept Resp Med, 1-1-1 Miwa, Kurashiki, Okayama 7108602, Japan

[2] Kyoto Univ, Grad Sch Med, Dept Resp Med, Sakyo Ku, 54 Kawahara Cho, Kyoto 6068507, Japan

来源：

RESPIRATORY MEDICINE CASE REPORTS | 2021年 / 33卷

关键词：

Non-small cell lung cancer; Small cell transformation; Alectinib; Anaplastic lymphoma kinase; ADENOCARCINOMA; RESISTANCE; CARCINOMA; MUTATIONS;

D O I：

10.1016/j.rmcr.2021.101440

中图分类号：

R56 [呼吸系及胸部疾病];

学科分类号：

摘要：

Small cell lung cancer (SCLC) transformation is a rare resistance mechanism to anaplastic lymphoma kinasetyrosine kinase inhibitors (ALK-TKIs), for which cytotoxic chemotherapy is often initiated. However, no case has been reported so far in which the SCLC component disappeared after chemotherapy and the tumor responded to ALK-TKI treatment again. A 41-year-old, never-smoker man was diagnosed with multiple metastatic lung adenocarcinoma harboring ALK gene rearrangements. After tumor re-growth was treated with alectinib, histological analysis of re-biopsy of the primary lesion showed combined small cell carcinoma, and cytotoxic chemotherapy was administered. After resistance to chemotherapy developed, the third biopsy of the primary lesion showed the original ALK gene rearrangements without the SCLC component. Alectinib was readministered, and partial response was obtained. Biopsy for ALK-positive lung cancer that progressed after chemotherapy for SCLC transformation might be useful for decision-making regarding the therapeutic strategy.

引用

页数：4

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