
Article in Japanese
A case of positive for ALK rearrangement lung adenocarcinoma that recurred in meningeal carcinomatosis during administration of crizotinib, improving after switching to alectinib
Yasukiyo Nakamura Toshikatsu Sado Yumi Nishihara Hiroko Fukata Tomoko Tajiri Hideo Kita
Department of Respiratory Medicine, Takatsuki Red Cross Hospital
A 51-year-old man was admitted with cough and lumbago, and multiple nodules were found in the right lung field in chest radiographs. He was diagnosed positive for anaplastic lymphoma kinase (ALK) rearrangement lung adenocarcinoma (cT4N3M1b Stage IV) with liver and multiple bone metastases, and crizotinib was started. Primary tumors of the lung were reduced, but headaches, vomiting, and weakness of the lower limbs gradually appeared and worsened. Magnetic resonance imaging (MRI) findings and cytology of the cerebrospinal fluid (CSF) were consistent with meningeal carcinomatosis (MC), and crizotinib was changed to alectinib. His symptoms rapidly improved except for the weakness of lower limbs, and MRI and CSF examinations also showed remarkable improvement of the MC. This case suggests that alectinib is effective in some patients with MC previously treated with crizotinib.
Non-small cell lung cancer (NSCLC) Positive for ALK rearrangement lung adenocarcinoma Meningeal carcinomatosis Alectinib
Received 5 Jan 2015 / Accepted 13 Feb 2015
AJRS, 4(2): 139-143, 2015