scholarly journals Anaplastic Lymphoma Kinase-Positive Lung Cancer with Mucoepidermoid Carcinoma Differentiation: A Case Report

2020 ◽  
Vol 13 (2) ◽  
pp. 1037-1041
Author(s):  
Toshio Sakatani ◽  
Yoshio Masuda ◽  
Teppei Morikawa ◽  
Kazuhiro Usui
Keyword(s):  
Lung Cancer ◽  
Anaplastic Lymphoma Kinase ◽  
Mucoepidermoid Carcinoma ◽  
Fusion Gene ◽  
Clinical Stage ◽  
Lower Lobe ◽  
Egfr Mutations ◽  
Rare Tumor ◽  
Genetic Characteristics ◽  
Anaplastic Lymphoma

Mucoepidermoid carcinoma (MEC) of the lung is an extremely rare tumor, and a standard chemotherapy has not been established. Furthermore, little work has been conducted on the genetic characteristics of MEC. We herein report the case of a 42-year-old nonsmoking male patient who was referred to our hospital due to cough. Chest computed tomography demonstrated infiltration and atelectasis in the right lower lobe. He was eventually diagnosed with non-small cell lung cancer (NSCLC) with MEC differentiation corresponding to clinical stage IVA (cT4N2M1a[PLE]). Genetic testing for EGFR mutations was negative, but positive for anaplastic lymphoma kinase (ALK) fusion gene. After 2 weeks of first-line treatment with alectinib, the tumor decreased in size and his symptoms improved. Advanced MEC is a rare tumor, and reports on the treatment of ALK-positive NSCLC with MEC differentiation are rare.

scholarly journals Alectinib-Induced Erythema Multiforme and Successful Rechallenge with Alectinib in a Patient with Anaplastic Lymphoma Kinase-Rearranged Lung Cancer

2016 ◽  
Vol 9 (3) ◽  
pp. 826-832 ◽  
Author(s):  
Tatsuo Kimura ◽  
Junko Sowa-Osako ◽  
Toshiyuki Nakai ◽  
Ayako Ohyama ◽  
Tomoya Kawaguchi ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Erythema Multiforme ◽  
Anaplastic Lymphoma Kinase ◽  
Fusion Gene ◽  
Skin Lesions ◽  
University Hospital ◽  
Oral Drug ◽  
Passive Smoker ◽  
Anaplastic Lymphoma ◽  
First Case

Background: Alectinib is an oral drug developed for the treatment of patients with fusion gene encoding echinoderm microtubule-associated protein-like 4-anaplastic lymphoma kinase (EML4-ALK)-rearranged non-small cell lung cancer (NSCLC). Here, we present the case of a patient treated with alectinib who developed a hypersensitivity reaction with successful rechallenge treatment. Case Presentation: A 39-year-old woman who was a passive smoker was referred to Osaka City University Hospital for the evaluation of a skin event caused by treatment for NSCLC with the fusion gene EML4-ALK. The skin reaction was observed on the anterior chest, upper arms, and ear auricles on day 11 of treatment with oral alectinib. The skin event presented as widely distributed erythematous macules that were confluent, indicating a severe and life-threatening form. The skin lesions started to resolve after the initiation of treatment with 40 mg prednisolone. After regrowth of the tumor, she received a rechallenge program for alectinib for 2 weeks; thereafter, alectinib treatment was successfully reinitiated. Conclusion: To the best of our knowledge, we present the first case in which alectinib, which binds to the adenosine triphosphate site of EML4-ALK, induced erythema multiforme. Moreover, successful readministration of alectinib through our rechallenge program has not been reported so far.

scholarly journals What are the Uncommon Anaplastic Lymphoma Kinase (ALK) Fusions in Non-Small Cell Lung Cancer?

2019 ◽  
Vol 6 ◽  
Author(s):  
Hind El Yacoubi ◽  
Mohamed Sow ◽  
Hassan Errihani
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Anaplastic Lymphoma Kinase ◽  
Fusion Gene ◽  
Small Cell ◽  
Small Cell Lung ◽  
Alk Rearrangement ◽  
Anaplastic Lymphoma ◽  
Cancer Pathogenesis

The lung cancer carcinogenesis is increasingly related to genetic disorders that lead to use specific targeted therapies which improve clinical outcome and survival. Gene fusion is one of the mechanisms of lung cancer pathogenesis besides gene mutation. The oncogenic echinoderm microtubule-associated protein-like 4-anaplastic lymphoma kinase (EML4-ALK) fusion gene was the first described in non small cell lung cancer (NSCLC) and it’s the most frequent ALK rearrangement which occurs in approximately 5% of NSCLC. The development of sequencing technology has allowed the discovery of other ALK partners that cause an ALK fusion in NSCLC. They are still less known, however. The aim of this revue is to report the novel ALK fusions in NSCLC described in the literature and their particular characteristics. We will present the kinesin family member 5B (KIF5B) - ALK fusion, the huntingtin interacting protein 1 (HIP 1)- ALK fusion, and other uncommon ALK fusions.  

scholarly journals Systematic Review and Network Meta-Analysis of Anaplastic Lymphoma Kinase (ALK) Inhibitors for Treatment-Naïve ALK-Positive Lung Cancer

Cancers ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 1966
Author(s):  
Cheng-Hao Chuang ◽  
Hsiao-Ling Chen ◽  
Hsiu-Mei Chang ◽  
Yu-Chen Tsai ◽  
Kuan-Li Wu ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Brain Metastasis ◽  
Anaplastic Lymphoma Kinase ◽  
Low Dose ◽  
Meta Analysis ◽  
Phase Iii ◽  
Pairwise Comparisons ◽  
Anaplastic Lymphoma ◽  
Treatment Naïve ◽  
Alk Positive

Several anaplastic lymphoma kinase inhibitors (ALKIs) have demonstrated excellent efficacy on overall survival (OS), progression-free survival (PFS), objective response rate (ORR), and also better adverse effect (AE) profiles compared to cytotoxic chemotherapy in advanced stage anaplastic lymphoma kinase (ALK) rearrangement-positive non-small cell lung cancer (NSCLC) in phase III randomized clinical trials (RCTs). We conducted this systematic review and network meta-analysis to provide a ranking of ALKIs for treatment-naïve ALK-positive patients in terms of PFS, ORR, and AEs. In addition, a sub-group analysis of treatment benefits in patients with baseline brain metastasis was also conducted. Contrast-based analysis was performed for multiple treatment comparisons with the restricted maximum likelihood approach. Treatment rank was estimated using the surface under the cumulative ranking curve (SUCRA), as well as the probability of being the best (Prbest) reference. All next-generation ALKIs were superior to crizotinib in PFS but lorlatinib and brigatinib had increased AEs. The probability of lorlatinib being ranked first among all treatment arms was highest (SUCRA = 93.3%, Prbest = 71.8%), although there were no significant differences in pairwise comparisons with high- (600 mg twice daily) and low- (300 mg twice daily) dose alectinib. In subgroup analysis of patients with baseline brain metastasis, low-dose alectinib had the best PFS (SUCRA = 87.3%, Prbest = 74.9%). Lorlatinib was associated with the best ranking for ORR (SUCRA = 90.3%, Prbest = 71.3%), although there were no significant differences in pairwise comparisons with the other ALKIs. In addition, low-dose alectinib had the best safety performance (SUCRA = 99.4%, Prbest = 97.9%). Lorlatinib and low-dose alectinib had the best PFS and ORR in the overall population and baseline brain metastasis subgroup, respectively. Low-dose alectinib had the lowest AE risk among the available ALKIs. Further head-to-head large-scale phase III RCTs are needed to verify our conclusions.

scholarly journals Disease Flare after Discontinuation of Crizotinib in Anaplastic Lymphoma Kinase-Positive Lung Cancer

2013 ◽  
Vol 6 (2) ◽  
pp. 430-433 ◽  
Author(s):  
Yuka Kuriyama ◽  
Young Hak Kim ◽  
Hiroki Nagai ◽  
Hiroaki Ozasa ◽  
Yuichi Sakamori ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Anaplastic Lymphoma Kinase ◽  
Disease Flare ◽  
Anaplastic Lymphoma
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