[A Case of Non-small Cell Lung Cancer Treated with Three ALK Inhibitors 
and Chemotherapy].

Abstract

The echinoderm microtubule associated protein-like 4 (EML4) and anaplastic lymphoma kinase (ALK) were fractured and fused to become EML4-ALK. Most of these EML4-ALK-positive non-small cell lung cancer patients respond well to the ALK inhibitor. Many patients can benefit from drug target therapy for a long time, and some patients can achieve long-term survival of more than 7 years under the optimized treatment mode. This patient has lung adenocarcinoma positive for EML4-ALK fusion gene, but the treatment outcome is obviously different from that of other patients with lung cancer positive for EML4-ALK fusion gene. After the first to third generations of ALK inhibitor targeted therapy and chemotherapy, the disease progresses rapidly, the drug resistance time is short, the survival time is short, and the benefit is limited. The patient received targeted therapy of Crizotinib, Ceritinib and Lorlatinib successively from July 15, 2019, followed by two chemotherapy courses of Bevacizumab combined with Pemetrexed and Carboplatin. The patient died on September 10, 2020, with a survival of 15 months. At the same time, the treatment showed common adverse reactions of ALK inhibitors. This paper analyzed the therapeutic effect and treatment dilemma of this patient, and provided an exploration direction for the treatment of patients with EML4-ALK fusion gene positive lung cancer.
.

• Authors: Jue Wang, Xiaoyan Xu, Yanyan Sun, Hui Li
• Journal: Zhongguo fei ai za zhi = Chinese journal of lung cancer (Zhongguo Fei Ai Za Zhi) Vol. 24 Issue 5 Pg. 372-376 (May 20 2021) ISSN: 1999-6187 [Electronic] China
• PMID: 34034462 (Publication Type: Case Reports, Journal Article)

Chemical References

• Aminopyridines
• Cell Cycle Proteins
• Lactams
• Microtubule-Associated Proteins
• Protein Kinase Inhibitors
• Pyrazoles
• Pyrimidines
• Sulfones
• Crizotinib
• ALK protein, human
• Anaplastic Lymphoma Kinase
• EML4 protein, human
• Serine Endopeptidases
• ceritinib
• lorlatinib

Topics

• Aminopyridines (therapeutic use)
• Anaplastic Lymphoma Kinase (antagonists & inhibitors, genetics, metabolism)
• Carcinoma, Non-Small-Cell Lung (drug therapy, genetics, metabolism)
• Cell Cycle Proteins (genetics, metabolism)
• Crizotinib (therapeutic use)
• Female
• Humans
• Lactams (therapeutic use)
• Lung Neoplasms (drug therapy, genetics, metabolism)
• Microtubule-Associated Proteins (genetics, metabolism)
• Middle Aged
• Protein Kinase Inhibitors (therapeutic use)
• Pyrazoles (therapeutic use)
• Pyrimidines (therapeutic use)
• Serine Endopeptidases (genetics, metabolism)
• Sulfones (therapeutic use)