Gürbüz Ali Fuat, Eryılmaz Melek Karakurt, Yıldız Oğuzhan, Kaya Bahattin Engin, Araz Murat, Artaç Mehmet
Department of Medical Oncology, Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey.
J Oncol Pharm Pract. 2025 Jan;31(1):160-163. doi: 10.1177/10781552241271791. Epub 2024 Aug 14.
Lorlatinib is a potent third-generation anaplastic lymphoma kinase/c-ros oncogene 1 (ALK)/ROS1 oral tyrosine kinase inhibitor that has broad coverage of acquired resistance mutations and is currently indicated for the treatment of adult patients with metastatic non-small cell lung cancer (NSCLC) whose tumors are ALK-positive.
In this case, we aimed to present the safety and effectiveness of lorlatinib use in a patient diagnosed with ALK-positive metastatic NSCLC who underwent hemodialysis 3 days a week.
MANAGEMENT & OUTCOME: A 76-year-old female patient has been undergoing regular hemodialysis for about 2 years. A brain magnetic resonance imaging (MRI) was taken due to headache and a mass was detected. She was diagnosed with lung adenocarcinoma as a result of excisional biopsy. Positron emission tomography/ computed tomography (PET/CT) showed a mass in the hilar region of the left lung and multiple lymphadenopathy in the mediastinum. In February 2023, 100 mg lorlatinib was started daily. There was no significant regression in PET-CT and no brain MRI residue during follow-up. The patient has been continuing lorlatinib for approximately 1 year with almost complete response, with no side effects other than hypercholesterolemia.
We presented our experience using lorlatinib in a patient with metastatic ALK + NSCLC undergoing hemodialysis. Although the dosage of lorlatinib in hemodialysis patients is still controversial, our case report indicates that 100 mg lorlatinib was safe in this patient.
洛拉替尼是一种强效的第三代间变性淋巴瘤激酶/c-ros癌基因1（ALK）/ROS1口服酪氨酸激酶抑制剂，对获得性耐药突变具有广泛的覆盖范围，目前适用于治疗肿瘤为ALK阳性的转移性非小细胞肺癌（NSCLC）成年患者。
在本病例中，我们旨在展示洛拉替尼在一名被诊断为ALK阳性转移性NSCLC且每周进行3次血液透析的患者中的安全性和有效性。
一名76岁女性患者已定期进行血液透析约2年。因头痛进行了脑部磁共振成像（MRI）检查，发现一个肿块。经切除活检，她被诊断为肺腺癌。正电子发射断层扫描/计算机断层扫描（PET/CT）显示左肺门区有一个肿块，纵隔有多处淋巴结病。2023年2月，开始每日服用100毫克洛拉替尼。随访期间，PET-CT检查未见明显消退，脑部MRI也未发现残留病灶。该患者持续服用洛拉替尼约1年，几乎完全缓解，除高胆固醇血症外无其他副作用。
我们介绍了在一名接受血液透析的转移性ALK+ NSCLC患者中使用洛拉替尼的经验。尽管血液透析患者中洛拉替尼的剂量仍存在争议，但我们的病例报告表明，100毫克洛拉替尼对该患者是安全的。
