Long-Term Response of Lorlatinib to Leptomeningeal Metastasis in Patients with Anaplastic Lymphoma Kinase Fusion Positive Non-Small Lung Cancer: A Case Report.

IF 0.7 Q4 ONCOLOGY

Case Reports in Oncology Pub Date : 2024-08-27 eCollection Date: 2024-01-01 DOI:10.1159/000540445

Yutaka Fujiwara, Katsuhiro Masago, Reiko Matsuzawa, Teppei Yamaguchi, Naohiro Watanabe, Junichi Shimizu, Eiichi Sasaki, Yoshitsugu Horio

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Abstract

Introduction: Patients with anaplastic lymphoma kinase (ALK)-rearranged non-small cell lung cancer (NSCLC) are at increased risk of central nervous system (CNS) metastasis at initial diagnosis and throughout treatment. In a phase 3 trial, lorlatinib, a third-generation ALK tyrosine kinase inhibitor, significantly improved progression-free survival. In further analysis, lorlatinib revealed superior intracranial efficacy and prolonged time to intracranial progression compared with crizotinib.

Case presentation: Herein, we report a case of ALK-positive NSCLC with leptomeningeal metastasis that was successfully treated with lorlatinib after progression to brigatinib and alectinib. This case demonstrates the potential of lorlatinib in managing leptomeningeal metastasis in ALK-positive NSCLC.

Conclusion: The case suggests a paradigm shift in therapeutic approaches for CNS metastasis, including brain and leptomeningeal metastases.

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洛拉替尼对无性淋巴瘤激酶融合阳性非小肺癌患者淋巴转移的长期反应：病例报告。

导言：无性淋巴瘤激酶（ALK）重组非小细胞肺癌（NSCLC）患者在初诊和整个治疗过程中发生中枢神经系统（CNS）转移的风险都在增加。在一项三期试验中，第三代ALK酪氨酸激酶抑制剂lorlatinib显著改善了无进展生存期。在进一步分析中，与克唑替尼相比，lorlatinib显示出更优越的颅内疗效，并延长了颅内进展时间：在此，我们报告了一例ALK阳性NSCLC伴颅内转移病例，该病例在使用布加替尼和阿来替尼治疗进展后，使用lorlatinib治疗获得成功。该病例证明了lorlatinib在治疗ALK阳性NSCLC脑膜转移方面的潜力：本病例表明，中枢神经系统转移（包括脑转移和脑膜转移）的治疗方法发生了范式转变。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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