Kuriyama Yuka, Kim Young Hak, Nagai Hiroki, Ozasa Hiroaki, Sakamori Yuichi, Mishima Michiaki
Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Case Rep Oncol. 2013 Aug 14;6(2):430-3. doi: 10.1159/000354756. eCollection 2013.
We report the case of a 50-year-old male former smoker. He was diagnosed as having lung adenocarcinoma and treated with induction chemoradiation therapy followed by surgery and adjuvant chemotherapy. Molecular testing revealed that his tumor had an echinoderm microtubule-associated protein-like 4-anaplastic lymphoma kinase (EML4-ALK) rearrangement. Therefore, he was treated with crizotinib when his disease recurred. He achieved a partial response, which persisted for 10 months until progressive disease was confirmed. Crizotinib was continued for 1 month and the tumor size increased slightly. At that time, crizotinib was discontinued and he participated in a clinical trial of erlotinib ± Met inhibitor; however, his disease progressed rapidly after discontinuation of crizotinib, and the diagnosis of disease flare was made. Readministration of crizotinib was started immediately; however, his disease progressed rapidly, and he died 2 days after starting crizotinib retreatment. Currently, the incidence of disease flare is unknown and it is impossible to predict who will experience it. Therefore, continuing crizotinib after disease progression may be a reasonable option to avoid disease flare.
我们报告了一例50岁的男性既往吸烟者的病例。他被诊断为肺腺癌，并接受了诱导放化疗，随后进行了手术和辅助化疗。分子检测显示他的肿瘤存在棘皮动物微管相关蛋白样4-间变性淋巴瘤激酶（EML4-ALK）重排。因此，疾病复发时他接受了克唑替尼治疗。他获得了部分缓解，这种缓解持续了10个月，直到确认疾病进展。克唑替尼持续使用了1个月，肿瘤大小略有增加。当时，停用了克唑替尼，他参加了厄洛替尼± 甲硫氨酸抑制剂的临床试验；然而，停用克唑替尼后他的疾病迅速进展，并诊断为疾病爆发。立即重新开始使用克唑替尼；然而，他的疾病迅速进展，在重新开始克唑替尼治疗2天后死亡。目前，疾病爆发的发生率尚不清楚，也无法预测谁会发生。因此，疾病进展后继续使用克唑替尼可能是避免疾病爆发的合理选择。
