| Autor: |
Metro G; Santa Maria della Misericordia Hospital, Azienda Ospedaliera di Perugia, Perugia, Italy., Baglivo S; Santa Maria della Misericordia Hospital, Azienda Ospedaliera di Perugia, Perugia, Italy., Metelli N; Santa Maria della Misericordia Hospital, Azienda Ospedaliera di Perugia, Perugia, Italy., Bonaiti A; Santa Maria della Misericordia Hospital, Azienda Ospedaliera di Perugia, Perugia, Italy., Matocci R; Santa Maria della Misericordia Hospital, Azienda Ospedaliera di Perugia, Perugia, Italy., Di Girolamo B; Oncologic Day Hospital, Santa Maria della Stella Hospital, Orvieto, Italy., Mandarano M; Section of Anatomic Pathology and Histology, Department of Medicine and Surgery, University of Perugia, Perugia, Italy., Colafigli C; Diagnostic Imaging, Santa Maria della Misericordia Hospital, Azienda Ospedaliera di Perugia, Perugia, Italy., Bellezza G; Section of Anatomic Pathology and Histology, Department of Medicine and Surgery, University of Perugia, Perugia, Italy., Roila F; Medical Oncology, Santa Maria della Misericordia Hospital, University of Perugia, Perugia, Italy., Ludovini V; Santa Maria della Misericordia Hospital, Azienda Ospedaliera di Perugia, Perugia, Italy. |
| Abstrakt: |
Lorlatinib is an active treatment for advanced anaplastic lymphoma kinase (ALK)-positive non-small cell lung cancer (NSCLC) pretreated with ALK-tyrosine kinase inhibitors (-TKIs). However, there is paucity of data on the activity of platinum/pemetrexed chemotherapy administered at the time of progression on lorlatinib. In addition, it is uncertain whether continuation of lorlatinib beyond progression (LBP) would provide any additional clinical benefit. Here, we describe two cases experiencing an exceptional response to platinum/pemetrexed chemotherapy plus LBP and make an attempt to identify which patients' characteristics and biologic profiles of the tumor could predict benefit from such an approach. In this report, presence of controlled brain metastases, rapidly progressing extracranial disease, and presence of ALK-dependent mechanisms of resistance were associated with benefit from platinum/pemetrexed chemotherapy plus lorlatinib beyond progression. |
