Onkologie 2020: 14(Suppl.B): 40-43 | DOI: 10.36290/xon.2020.035

When not even four ALK inhibitors are enough

Martin Svatoň¹, Jan Baxa², Petr Mukenšnabl³, Tomáš Vaněček⁴, Miloš Pešek¹

¹ Klinika pneumologie a ftizeologie, FN Plzeň a LF UK v Plzni

² Klinika zobrazovacích metod, FN Plzeň

³ Šiklův ústav patologie, FN Plzeň

⁴ Bioptická laboratoř, s. r. o., Plzeň

Our case report describes a non-smoker with generalized pulmonary adenocarcinoma with ALK translocation. After the first two lines of chemotherapy, access to crizotinib was obtained. However, very soon, a second, small-sized lesion has developed, described as a metastasis in the contralateral lung. Subsequent use of higher generation ALK inhibitors (ceritinib, alectinib, lorlatinib) did not prevent progression in the right lung. It was shown later that the cause of this progression is not metastatic spread of adenocarcinoma in the right lung, but transformation to squamous lung carcinoma with ALK translocation. With this article, we would like to draw your attention to this eventuality, when rebiopsy of progressive lesion should be considered in case of atypical radiological development of lung cancer.

Keywords: non-small cell lung cancer, ALK translocation, tyrosine kinase inhibitors.

Published: June 2, 2020  Show citation