Department of Medical Oncology, Cantonal Hospital of Winterthur, Winterthur, Switzerland.
Department of Urology, Cantonal Hospital of Winterthur, Winterthur, Switzerland.
Urology. 2020 Dec;146:32-35. doi: 10.1016/j.urology.2020.09.026. Epub 2020 Sep 30.
Inflammatory myofibroblastic tumors are rare tumors with an ALK (anaplastic lymphoma kinase) gene rearrangement in up to 65% of all cases. In our patient, the tumor was not primary resectable due to its extension. Under neoadjuvant treatment with the first generation ALK inhibitor crizotinib no tumor response was seen, but the following therapy with the next generation ALK inhibitor lorlatinib led to a rapid and deep response, enabling a complete tumor resection by partial cystectomy. Our case indicates that ALK positive inflammatory myofibroblastic tumors which do not respond to ALK inhibition with crizotinib can be successfully treated with newer agents.
炎性肌纤维母细胞瘤是一种罕见的肿瘤，高达 65%的病例存在 ALK（间变性淋巴瘤激酶）基因重排。在我们的患者中，由于肿瘤的延伸，其无法进行初次切除。在接受第一代 ALK 抑制剂克唑替尼的新辅助治疗下，肿瘤没有任何反应，但随后使用下一代 ALK 抑制剂劳拉替尼进行治疗，导致了快速而深度的反应，从而能够通过部分囊切除术实现肿瘤的完全切除。我们的病例表明，对于那些对克唑替尼的 ALK 抑制没有反应的 ALK 阳性炎性肌纤维母细胞瘤，可以成功地使用新型药物进行治疗。
