Successful Treatment of a Resistant Subclone in ALK-Rearranged NSCLC

Autor: David König, Urs R. Meier, Bernd Klaeser, Spasenija Savic, Miklos Pless
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Zdroj: Case Reports in Oncology, Vol 13, Iss 2, Pp 729-732 (2020)
Druh dokumentu: article
ISSN: 1662-6575
DOI: 10.1159/000507850
Popis: Anaplastic lymphoma kinase (ALK) tyrosine kinase inhibitors (TKIs) are established effective therapies in patients with ALK-rearranged advanced non-small-cell lung cancer (NSCLC). Upon progressive disease, patients normally receive a subsequent ALK TKI. However, when disease progression occurs in a limited number of sites, an oligoprogressive approach is a treatment option. In our case, FDG-PET/CT scan detected a progressive site in a patient with ceritinib therapy. Biopsy of the lesion was not possible because of its location. Progression was therefore confirmed by liquid biopsy with identification of the resistant subclone ALK G1202R. Definitive radiotherapy of the progressive site led to the disappearance of the ALK-resistant mutation. Meanwhile, ceritinib therapy was continued. The absence of disease both on repeated imaging and liquid biopsy indicates that eradication of a resistant subclone with an oligoprogressive treatment approach might be possible.
Databáze: Directory of Open Access Journals
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