Bai Henan, Han Yu, Niu Yi, Zhang Minghui
Department of Oncology, Chifeng City Hospital, Chifeng 024000, China.
Zhongguo Fei Ai Za Zhi. 2021 Aug 20;24(8):598-604. doi: 10.3779/j.issn.1009-3419.2021.101.32. Epub 2021 Aug 4.
Anaplastic lymphoma kinase (ALK) is an important therapeutic target for advanced non-small cell lung cancer (NSCLC). In recent years, with the emergence of several ALK tyrosine kinase inhibitors (TKI), the overall survival (OS) of ALK fusion positive patients is gradually extended. This paper reports the treatment of a late stage non-small cell lung cancer (NSCLC) patient with ALK fusion positive for more than 5 years, and analyzes the treatment process and effect evaluation, so as to provide experience for the follow-up treatment of patients.
The diagnosis and treatment process of a patient with advanced ALK fusion mutation positive lung cancer admitted to the third ward of Department of oncology, Chifeng hospital, Inner Mongolia on July 3, 2015 was retrospectively analyzed.
A 42 years old male patient was admitted to our department on July 3, 2015 for "intermittent cough, chest tightness for 2 months, diagnosed with lung adenocarcinoma for 1 day". Imaging examination showed a space occupying lesion in the left lower lobe of the lung, accompanied by mediastinal lymphadenopathy and left encapsulated pleural effusion. Bronchoscopic pathology showed non-small cell carcinoma, and adenocarcinoma was tentatively suggested.
left lower lobe adenocarcinoma T1bN2M1a stage IV. Fluorescence in situ hybridization (FISH) indicated the translocation of ALK (2p23) chromosome. After 2 cycles of docetaxel+cisplatin (DP) regimens chemotherapy, disease progression occurred, so we used 6 cycles of pemetrexed+carboplatin to apply combination chemotherapy, 4 cycles of pemetrexed monotherapy were used after that. The efficacy evaluation: PR. On April 9, 2016, the patient was treated with crizotinib. In August 2019, multiple intracranial metastases were found and whole brain radiotherapy was given. Since September 4, 2019, oral administration of nsatinib has been carried out. As of March 1, 2021, the patients were followed up well.
The advanced ALK fusion positive lung adenocarcinoma patients, though the first-line and the second-line chemotherapy, and the follwing application of ALK-TKI treatment, has procured a total OS has reached 68 months, and the current follow-up is good.
间变性淋巴瘤激酶（ALK）是晚期非小细胞肺癌（NSCLC）的重要治疗靶点。近年来，随着多种ALK酪氨酸激酶抑制剂（TKI）的出现，ALK融合阳性患者的总生存期（OS）逐渐延长。本文报道1例ALK融合阳性晚期非小细胞肺癌（NSCLC）患者5年余的治疗情况，并分析其治疗过程及疗效评估，为患者后续治疗提供经验。
回顾性分析2015年7月3日内蒙古赤峰市医院肿瘤科三病区收治的1例晚期ALK融合突变阳性肺癌患者的诊断及治疗过程。
1例42岁男性患者于2015年7月3日因“间断咳嗽、胸闷2个月，确诊肺腺癌1天”入院。影像学检查显示左肺下叶占位性病变，伴有纵隔淋巴结肿大及左侧包裹性胸腔积液。支气管镜病理显示非小细胞癌，初步考虑为腺癌。
左肺下叶腺癌T1bN2M1a Ⅳ期。荧光原位杂交（FISH）检测提示ALK（2p23）染色体易位。多西他赛+顺铂（DP）方案化疗2周期后疾病进展，换用培美曲塞+卡铂联合化疗6周期，之后采用培美曲塞单药化疗4周期。疗效评估：PR。2016年4月9日患者接受克唑替尼治疗。2019年8月发现多发颅内转移，给予全脑放疗。自2019年9月4日起口服恩扎替尼。截至2021年3月1日，患者随访情况良好。
晚期ALK融合阳性肺腺癌患者，经一线及二线化疗，后续应用ALK-TKI治疗，总OS达68个月，目前随访情况良好。
