Replacement of ALK inhibitors as an effective strategy for reducing drug toxicity in non-small cell lung cancer patients with ALK gene rearrangement

IF 0.3 Q4 ONCOLOGY
M. Gil, I. Chmielewska, P. Krawczyk, Przemysław Niziński, M. Strzemski, J. Milanowski
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引用次数: 0

Abstract

This case report examines the effects of replacement of anaplastic lymphoma kinase inhibitor (ALKi) as a strategy to reduce drug toxicity in patients with non-small cell lung cancer (NSCLC) with ALK gene rearrangements. A 61-year-old female patient with lung adenocarcinoma encountered difficulties in ALK abnormalities diagnosis: the expression of abnormal ALK protein was not detected by the immunohistochemistry (IHC) assay, but ALK gene rearrangement was present in next generation sequencing (NGS) and fluorescence in situ hybridization (FISH) assays. The patient was initially treated with second-generation ALKi (alectinib). However, the patient experienced severe hepatotoxicity. She was successfully switched to brigatinib (another second-generation ALK inhibitor). During brigatinib therapy, a transient increase in creatinine kinase concentration was observed, which required brigatinib dose reduction. Effectiveness of both anti-ALK agents was observed (partial response to treatment, followed by disease stabilization). This case report illustrates the difficulties in diagnosing ALK gene rearrangements and the possibility of replacing ALK inhibitors without compromising treatment efficacy.
替代ALK抑制剂作为降低ALK基因重排非小细胞肺癌患者药物毒性的有效策略
本病例报告探讨了替代间变性淋巴瘤激酶抑制剂(ALKi)作为降低ALK基因重排的非小细胞肺癌(NSCLC)患者药物毒性的策略的效果。1例61岁女性肺腺癌患者ALK异常诊断遇到困难:免疫组化(IHC)检测未检测到异常ALK蛋白的表达,但下一代测序(NGS)和荧光原位杂交(FISH)检测发现ALK基因重排。患者最初接受第二代ALKi (alectinib)治疗。然而,患者出现了严重的肝毒性。她成功地改用布加替尼(另一种第二代ALK抑制剂)。在布加替尼治疗期间,观察到肌酸酐激酶浓度的短暂增加,这需要减少布加替尼的剂量。观察两种抗alk药物的有效性(对治疗的部分反应,随后疾病稳定)。本病例报告说明了诊断ALK基因重排的困难,以及在不影响治疗效果的情况下替代ALK抑制剂的可能性。
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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来源期刊
CiteScore
0.90
自引率
20.00%
发文量
46
审稿时长
15 weeks
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