EXCELLENT RESPONSE TO ALECTINIB IN ALK-POSITIVE NSCLC ADENOCARCINOMA-A CASE REPORT AND LITERATURE REVIEW

Abstract

Non small cell lung carcinoma (NSCLC) is a type of lung carcinoma that slowly grows within the lungtissue, thus it is often diagnosed lately when the disease has already progressed and passed to otherbody organs and/or lymph nodes. This makes NSCLC in most of the cases inoperable at the exactmoment of diagnosing, which leads to a necessity of using a chemotherapy that has the purpose ofnarrowing the extended masses in the lungs and/or near/further metastases. Alectinib is a tyrosine-kinase inhibitor (TKI) that is currently being used as a first line target therapy in treating theinoperable ALK rearranged NSCLC, but still the effectiveness of the treatment is not definitely knownand examined. Herein, we report a case of a 51-year-old male patient presented to our hospital withhemoptysis for 2 weeks. Contrast-enhanced computerized tomography (CT) of the chest showed anapproximately 28x23 mm soft tissue mass infiltrating into the lumen of the right bronchus and causingobstruction. On the same side at the base, a hypodense nodule of 19 mm with some surroundingpneumonic reaction and irregular contours was detected. Several significant lymph nodes were detectedin the hilar and mediastinal regions. Transobronchial biopsy of the mass showed pulmonaryadenocarcinoma and immunohistochemical testing results confirmed ALK rearrangements. TKIalectinib was given at a dosage of 600mg twice per day for 13 cycles, achieving a complete response ofthe disease with complete regression of the mass in the right bronchus, complete regression of the rightnodule and hilar and mediastinal lymph nodes were not detected after treatment . The patientcontinued to receive alectinib and did not report any specific discomfort at his 13 month follow-up. Keywords: NSCLC, Lung adenocarcinoma, ALK rearrangement, TKIs, Alectinib