Perioperative alectinib in a patient with locally advanced anaplastic lymphoma kinase positive non-small cell lung cancer (NSCLC): a case report.

Content Provider	Europe PMC
Author	Yue, Ping Zhang, Shengxiong Zhou, Ling Xiang, Jie Zhao, Shengguang Chen, Xiaoyan Dong, Lei Yang, Wenjie Xiang, Yi
Copyright Year	2021
Abstract	We reported a case of locally advanced anaplastic lymphoma kinase (ALK) positive non-small cell lung cancer (NSCLC) patient who received neoadjuvant alectinib therapy. Enhanced computed tomography (CT) scan was performed after the first cycle of alectinib therapy to evaluate the efficacy of neoadjuvant alectinib. Surprisingly, the tumor shrunk 42.2% after one cycle treatment. Partial remission (PR) was achieved without any side effects, although the tumor stage didn’t degrade. Then right upper lobectomy and mediastinal lymph node dissection by video assistant thoracoscopic surgery (VATS) were successfully performed after multi-disciplinary team meeting with the department of respiratory, thoracic surgery, radiotherapy (RT), pathology and radiology. Pathologic evaluation about tumor was assessed by hematoxylin and eosin staining. However, the residual viable tumor cells were 15%, which indicated that major pathologic response (MPR) was not achieved. Next, continually adjuvant alectinib and RT were given because mediastinal station 4R lymphadenectomy excluded with serious tissue adhesion and MPR status was not met. In this case, we presented neoadjuvant alectinib therapy was feasible and well tolerated in locally advanced ALK positive NSCLC, inspiring clinical studies to further assess its clinical implication in treating patients with locally advanced ALK-positive NSCLC. And we also discussed the necessary time of neoadjuvant and adjuvant alectinib in advanced ALK-positive NSCLC.
ISSN	2218676X
Journal	Translational Cancer Research
Volume Number	10
PubMed Central reference number	PMC8799071
Issue Number	8
PubMed reference number	35116684
e-ISSN	22196803
DOI	10.21037/tcr-21-642
Language	English
Publisher	AME Publishing Company
Publisher Date	2021-08-01
Access Restriction	Open
Rights License	Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/. 2021 Translational Cancer Research. All rights reserved.
Subject Keyword	Locally advanced non-small cell lung cancer (locally advanced NSCLC) anaplastic lymphoma kinase (ALK) perioperative target therapy alectinib case report
Content Type	Text
Resource Type	Article
Subject	Radiology, Nuclear Medicine and Imaging Cancer Research Oncology