Von Cheong E, Fuang Ho Gwo
Department of Clinical Oncology, First Floor Menara Timur, University of Malaya Medical Centre, Lembah Pantai, 59100, Kuala Lumpur, Malaysia.
Faculty of Medicine, University of Malaya, Malaysia.
Respir Med Case Rep. 2021 Jul 13;34:101478. doi: 10.1016/j.rmcr.2021.101478. eCollection 2021.
The development of resistance to tyrosine kinase inhibitors (TKIs) in metastatic non-small cell lung cancer (NSCLC) with oncogenic driver mutations highlights the challenge in improving the survival of these patients. The standard of care for ALK-rearranged advanced NSCLC refractory to various generations of ALK TKIs falls back to the use of chemotherapy and the prognosis remains poor. We report the case of a 41-year-old lady with an ALK-translocated metastatic lung adenocarcinoma, who demonstrated good response to an immune checkpoint inhibitor, atezolizumab in combination with bevacizumab and chemotherapy (pemetrexed and carboplatin), following disease progression on three generations of ALK TKIs. Six months into treatment, she continues to show improvement in her health-related quality of life and is tolerating treatment well. Our case suggests that this treatment regimen is a potential treatment option for TKI-refractory driver-mutated NSCLC.
在具有致癌驱动基因突变的转移性非小细胞肺癌（NSCLC）中，对酪氨酸激酶抑制剂（TKIs）产生耐药性凸显了改善这些患者生存率的挑战。对于对各代ALK TKIs均耐药的ALK重排晚期NSCLC，护理标准退回到使用化疗，且预后仍然很差。我们报告了一例41岁女性ALK易位转移性肺腺癌患者，在三代ALK TKIs治疗疾病进展后，对免疫检查点抑制剂阿特珠单抗联合贝伐单抗及化疗（培美曲塞和卡铂）表现出良好反应。治疗六个月后，她的健康相关生活质量持续改善，且对治疗耐受性良好。我们的病例表明，这种治疗方案是TKI难治性驱动基因突变NSCLC的一种潜在治疗选择。
