A non-small cell lung carcinoma patient responded to crizotinib therapy after alectinib-induced interstitial lung disease.
10.3724/zdxbyxb-2023-0319
- Author:
Wenjia SUN
1
;
Jing ZHENG
2
;
Jianya ZHOU
3
;
Jianying ZHOU
2
Author Information
1. Department of Respiratory Disease, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China. sunwenjia@zju.edu.cn.
2. Department of Respiratory Disease, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.
3. Department of Respiratory Disease, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China. zhoujy@zju.edu.cn.
- Publication Type:Journal Article
- Keywords:
Adenocarcinoma;
Case report;
Interstitial lung disease;
Targeted therapy;
Tyrosine kinase inhibitor
- MeSH:
Female;
Humans;
Middle Aged;
Carcinoma, Non-Small-Cell Lung/drug therapy*;
Crizotinib/therapeutic use*;
Lung Neoplasms/drug therapy*;
Anaplastic Lymphoma Kinase/therapeutic use*;
Lung Diseases, Interstitial/diagnosis*
- From:
Journal of Zhejiang University. Medical sciences
2023;52(5):583-587
- CountryChina
- Language:English
-
Abstract:
A 54-year-old, non-smoking woman was diagnosed as stage ⅣB adenocarcinoma with widespread bone metastasis (cT4N2M1c) in the First Affiliated Hospital, Zhejiang University School of Medicine. Immunohistochemistry result showed the presence of anaplastic lymphoma kinase (ALK) gene rearrangement; next-generation sequencing (NGS) indicated EML4-ALK fusion (E6:A20) with concurrent CCDC148-ALK (C1:A20), PKDCC-ALK (Pintergenic:A20)and VIT-ALK (V15:A20) fusions. After 32 weeks of alectinib treatment, the patient complained cough and exertional chest distress but had no sign of infection. Computed tomography (CT) showed bilateral diffuse ground glass opacities, suggesting a diagnosis of alectinib-related interstitial lung disease (ILD). Following corticosteroid treatment and discontinuation of alectinib, clinical presentations and CT scan gradually improved, but the primary lung lesions enlarged during the regular follow-up. The administration of crizotinib was then initiated and the disease was stable for 25 months without recurrence of primary lung lesions and ILD.
