scholarly journals CONTEMPORARY TREATMENT OF ALK POSITIVE NON SMALL CELL LUNG CANCER PATIENT WITH BRAIN METASTASES: OUR EXPERIENCE

2020 ◽  
Vol 4 (1) ◽  
Author(s):  
S Crvenkova ◽  
Popova M
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Fusion Gene ◽  
Performance Status ◽  
Small Cell ◽  
Poor Performance Status ◽  
Small Cell Lung ◽  
Anaplastic Lymphoma ◽  
Nsclc Patients

Purpose: The aim of this study is to show alectinib efficacy and safety, with focus on alectinib intracranial efficacy. Case presentation: We report on a 46-year-old woman diagnosed as non small cell lung cancer harboring echinoderm microtubule-associated protein-like 4-anaplastic lymphoma kinase fusion gene. She has intracranial metastases and poor performance status of 3. We treated this patients with alectinib after whole brain irradiation and discontinuation of chemotherapy after two 2 cycles due to progressive brain and liver metastases. Good response was obtained with improving of her performance status without adverse events.   Conclusions: We recommend alectinib as a treatment approach for ALK+ NSCLC patients, especially those with CNS metastases at the time of the diagnosis and poor PS. Key words: CNS metastasis, ALK+ NSCLC patients, alectinib

scholarly journals Alectinib Treatment of ALK Positive Non Small Cell Lung Cancer Patients with Brain Metastases: Our Clinical Experience

PRILOZI ◽  
2020 ◽  
Vol 41 (2) ◽  
pp. 29-36
Author(s):  
Simonida Crvenkova
Keyword(s):  
Lung Cancer ◽  
Brain Metastases ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Performance Status ◽  
Small Cell ◽  
Poor Performance Status ◽  
Small Cell Lung ◽  
Anaplastic Lymphoma ◽  
Nsclc Patients

AbstractSummary: Anaplastic lymphoma kinase (ALK) rearrangement is identified in approximately 3-7% of all metastatic non-small cell lung cancer (NSCLC) patients, and ALK tyrosine kinase inhibitors (TKIs) have revolutionized the management of this subset of lung cancer cases.Purpose: This study aims to show alectinib (TKI) effectiveness and safety with focus on alectinib intracranial efficacy for ALK+ NSCLC patients.Case presentation: Patient 1 was a 46-year-old woman diagnosed with non-small cell lung cancer with an echinoderm microtubule-associated protein-like 4-anaplastic lymphoma kinase fusion gene (ALK+). She presented with intracranial and liver metastases and poor performance status of ECOG 3. Alectinib was initiated as a second line therapy, after whole brain irradiation and discontinuation of first line chemotherapy after two cycles, due to the central nervous system progression and liver metastases. Good response was consequently achieved, characterized with improved overall performance and without significant adverse events.Patient 2 was a 53-year old man with left sided lung adenocarcinoma surgically treated in 2017. Post-operative pTNM stage was IIB with a positive resection margin- R1. He received adjuvant chemotherapy and radiotherapy. In 2019, after two and half years of being disease free, he presented with severe cerebral symptoms leading to poor performance status. CT scan of the brain showed multiple brain metastases. He was treated with first line alectinib after completion of whole brain radiotherapy. In 5 months period he got significantly better and able for work again.Conclusions: We recommend alectinib as a first and second line treatment approach for ALK+ NSCLC patients, in particular the ones with brain metastases at the time of diagnosis and poor PS.

scholarly journals Feasibility and effectiveness of afatinib for poor performance status patients with EGFR-mutation-positive non-small-cell lung cancer: a retrospective cohort study

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Chiao-En Wu ◽  
Ching-Fu Chang ◽  
Chen-Yang Huang ◽  
Cheng-Ta Yang ◽  
Chih-Hsi Scott Kuo ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Prognostic Factors ◽  
Small Cell Lung Cancer ◽  
Disease Control ◽  
Performance Status ◽  
Poor Performance ◽  
Small Cell ◽  
Poor Performance Status ◽  
Small Cell Lung ◽  
Nsclc Patients

Abstract Background Afatinib is one of the standard treatments for patients with epidermal growth factor receptor (EGFR)-mutated non-small-cell lung cancer (NSCLC). However, data on the use of afatinib in patients with poor performance status (PS ≥ 2) are limited. This study aimed to retrospectively review the clinical outcomes and safety of afatinib treatment in EGFR-mutation-positive (EGFRm+) NSCLC patients with PS ≥ 2. Methods The data for 62 patients who were treated at Linkou Chang Gung Memorial Hospital from January 2010 to August 2019 were retrospectively reviewed. Patients’ clinicopathological features were obtained, and univariate and multivariate analyses were performed to identify possible prognostic factors. Data on adverse events were collected to evaluate general tolerance for afatinib therapy. Results Until February 2020, the objective response rate, disease control rate, median progression-free survival (PFS), and overall survival (OS) were 58.1% (36/62), 69.4% (43/62), 8.8 months, and 12.9 months, respectively. The absence of liver metastasis (PFS: p = 0.044; OS: p = 0.061) and good disease control (p < 0.001 for PFS and OS) were independent favorable prognostic factors for PFS and OS. Bone metastasis (p = 0.036) and dose modification (reduction/interruption, p = 0.021) were predictors of disease control. Conclusion Afatinib demonstrated acceptable efficacy and safety in the current cohort. This study provided evidence to support the use of afatinib as a first-line treatment in EGFRm+ NSCLC patients with poor PS.

scholarly journals Efficacy of Alectinib in ALK-Positive Non-Small Cell Lung Cancer with Leptomeningeal Metastases Pretreated with Crizotinib

2021 ◽  
Author(s):  
zhiqin lu ◽  
Yuanyuan Liang ◽  
Xia Wang ◽  
Zhimin Zeng ◽  
Congying Zhong ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Clinical Symptoms ◽  
Performance Status ◽  
Small Cell ◽  
Poor Performance Status ◽  
Small Cell Lung ◽  
Specific Patient ◽  
Alk Positive

Abstract PurposeLeptomeningeal metastases is a fatal complication of advanced non-small cell lung cancer (NSCLC). This study aimed to assess the clinical efficacy of alectinib in ALK-positive NSCLC with LM patients previously treated with crizotinib.MethodsRetrospective study of NSCLC patients with alectinib-treated ALK- positive NSCLC and LM.ResultsFourteen patients (mean age, 55 years; 50% women) with adenocarcinoma NSCLC were included in the study. Before starting alectinib, all patients were treated with crizotinib. When LM was diagnosed, all patients had clinical symptoms. Sixteen (50%) patients had a performance status>2. Of 14 total patients, 85.7% (12/14) of the patients had a clinical and radiological responses. From the start of alectinib, median OS and PFS were 17.4 (95% CI, 8.9–25.9) and 11.6 months (95% CI: 8.4–14.8), respectively, one-year survival rate was 57.1%.ConclusionAlectinib had significant efficacy against NSCLC with LM, this efficacy was rapid in several patients, even some with poor performance status. Alectinib might be a suitable option for specific patient populations with advanced ALK-positive NSCLC with LM.

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