Li Xiaoyan, Liu Xiaoqing, Gao Fang, Yin Xiaodan
Department of Lung Cancer, 307 Hospital of PLA, Affiliated to Academy of Military Medical Sciences, Beijing 100071, China.
Zhongguo Fei Ai Za Zhi. 2015 Feb;18(2):85-8. doi: 10.3779/j.issn.1009-3419.2015.02.06.
Distant metastasis was common in lung cancer, especially patients with bone marrow metastasis had poor prognosis and there were few effective methods. Crizotinib had been confirmed to be used in anaplastic lymphoma kinase (ALK) positive lung adenocarcinoma, but the efficacy in lung cancer with bone marrow metastasis was unknown. In the present study, we reported one case of ALK-positive lung adenocarcinoma with bone marrow matastasis given crizotinib treatment, the safety and efficacy was summarized.
ALK fusion was tested by fluorescence in situ hybridization (FISH). Crizotinib was given with dose of 250 mg, bid. Objective response was evaluated by Response Evaluation Criteriation in Solid Tumours (RECIST) v1.1 and bone marrow response was evaluated by bone marrow puncture and biopsy. Adeverse events were evaluated according to Common Terminology Criteria for Adverse Events (CTC AE) v4.0.
The patient achieved partial response (PR) after 6 weeks of crizotinib, especially the objective response of bone marrow metastasis was complete response (CR). The patient stopped crizotinib because of pneumonia. The progression free survival (PFS) and overall survival (OS) was 20 weeks and 22 weeks respectively.
Crizotinib could be an effective method for ALKpositive lung cancer with bone marrow metastasis and showed good tolerance.
远处转移在肺癌中很常见，尤其是骨髓转移患者预后较差且有效治疗方法较少。克唑替尼已被证实可用于间变性淋巴瘤激酶（ALK）阳性肺腺癌，但在伴有骨髓转移的肺癌中的疗效尚不清楚。在本研究中，我们报告了1例接受克唑替尼治疗的ALK阳性肺腺癌伴骨髓转移患者，总结了其安全性和疗效。
采用荧光原位杂交（FISH）检测ALK融合情况。克唑替尼给药剂量为250mg，每日2次。根据实体瘤疗效评价标准（RECIST）v1.1评估客观缓解情况，通过骨髓穿刺和活检评估骨髓反应。根据不良事件通用术语标准（CTC AE）v4.0评估不良事件。
克唑替尼治疗6周后患者达到部分缓解（PR），尤其是骨髓转移的客观反应为完全缓解（CR）。患者因肺炎停用克唑替尼。无进展生存期（PFS）和总生存期（OS）分别为20周和22周。
克唑替尼可能是治疗ALK阳性伴骨髓转移肺癌的有效方法，且耐受性良好。
