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Liang L, Mao M, Wu L, Chen T, Lyu J, Wang Q, Li T. Efficacy and Drug Resistance Analysis of ALK Inhibitors in Combination with Stereotactic Body Radiation Therapy for Treating Lung Squamous Carcinoma Patient Harboring EML4-ALK Rearrangement. Onco Targets Ther 2021; 14:5385-5389. [PMID: 34887666 PMCID: PMC8652916 DOI: 10.2147/ott.s335736] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Accepted: 11/19/2021] [Indexed: 12/13/2022] Open
Abstract
EML4-ALK rearrangement is common in lung adenocarcinoma. The ALK inhibitors remarkably inhibit lung adenocarcinoma and reveal long-term beneficial effects in several patients. Advanced genetic testing technology reveals that EML4-ALK rearrangement has been observed in patients with lung squamous cell carcinoma. In the present study, we report a case of a 53-year-old patient with EML4-ALK rearranged in lung squamous carcinoma; PET/CT scan revealed brain and multiple bone metastases. First-line ALK-TKI combined with local stereotactic body radiation therapy indicated progression-free survival of 9 months. After progressive disease, treatment was switched to lorlatinib, with little efficacy and a total overall survival of 11 months. The emergence of drug resistance revealed that the genetic test result was EML4-ALK fusion (V3a/b variants), indicating a poor prognosis. In this study, we analyzed the treatment efficacy of ALK inhibitors and provided a research basis for the treatment of EML4-ALK rearranged in lung squamous cell carcinoma patients.
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Affiliation(s)
- Long Liang
- Department of Radiation Oncology, Sichuan Cancer Hospital and Institution, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Radiation Oncology Key Laboratory of Sichuan Province, Chengdu, People's Republic of China
| | - Mian Mao
- Department of Pharmacy, Sichuan Cancer Hospital & Institute, Sichuan Cancer Centre, School of Medicine, University of Electronic Science and Technology of China, Chengdu, People's Republic of China
| | - Lei Wu
- Department of Radiation Oncology, Sichuan Cancer Hospital and Institution, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Radiation Oncology Key Laboratory of Sichuan Province, Chengdu, People's Republic of China
| | - Taiyu Chen
- Clinical Medical College of Chengdu Medical College, Chengdu, 610500, People's Republic of China
| | - Jiahua Lyu
- Department of Radiation Oncology, Sichuan Cancer Hospital and Institution, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Radiation Oncology Key Laboratory of Sichuan Province, Chengdu, People's Republic of China
| | - Qifeng Wang
- Department of Radiation Oncology, Sichuan Cancer Hospital and Institution, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Radiation Oncology Key Laboratory of Sichuan Province, Chengdu, People's Republic of China
| | - Tao Li
- Department of Radiation Oncology, Sichuan Cancer Hospital and Institution, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Radiation Oncology Key Laboratory of Sichuan Province, Chengdu, People's Republic of China
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Tian Y, Tian T, Yu P, Ren L, Gong Y, Yao W, Zhang X, Yin J, He L, Chen L, Wang K, Huang M, Li J. [Safety and Preliminary Efficacy of Ceritinib 450 mg with Food in Chinese ALK-positive Non-small Cell Lung Cancer]. ZHONGGUO FEI AI ZA ZHI = CHINESE JOURNAL OF LUNG CANCER 2021; 23:655-661. [PMID: 32838488 PMCID: PMC7467981 DOI: 10.3779/j.issn.1009-3419.2020.102.33] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
背景与目的 间变性淋巴瘤激酶(anaplastic lymphoma kinase, ALK)染色体易位为非小细胞肺癌(non-small cell lung cancer, NSCLC)常见的驱动基因。塞瑞替尼为第二代的ALK抑制剂, 可为ALK阳性转移性NSCLC患者带来生存获益, 但国内尚无塞瑞替尼用药安全性及疗效的研究报道。因此本研究拟通过真实世界研究来探讨塞瑞替尼450 mg随餐服用治疗中国ALK阳性NSCLC患者的安全性及近期疗效。 方法 回顾性分析2018年10月-2019年12月期间就诊于四川省8家医疗机构口服塞瑞替尼450 mg/d随餐治疗的ALK阳性NSCLC患者, 收集患者基本信息、治疗期间不良事件(adverse effects, AEs)及疗效数据等资料, 评价其安全性及初步疗效。 结果 研究共纳入109例患者, 随访至2020年1月23日, 中位服药时间为5.87个月(范围：0.4个月-15.7个月), 总体不良事件发生率为89.9%, 3级-4级不良事件发生率为22.9%。最常见AEs(主要为1级-2级)为腹泻(60.6%)、丙氨酸氨基转移酶(alanine aminotransferase, ALT)升高(38.5%)及门冬氨酸氨基转移酶(aspartate aminotransferase, AST)升高(37.6%)。至随访截止, 共45例患者停药, 总体客观缓解率(objective response rate, ORR)为37.6%(95%CI: 28.5%-47.4%), 疾病控制率(disease control rate, DCR)为86.2%(95%CI: 78.3%-92.1%)。 结论 真实世界中, 塞瑞替尼450 mg随餐服用的给药方式在中国ALK阳性NSCLC患者中具有良好的安全性及疾病控制率, 但需要更大样本量的前瞻性研究来进一步验证。
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Affiliation(s)
- Yuke Tian
- Department of Medical Oncology, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610041, China
| | - Tian Tian
- Department of Thoracic Oncology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Ping Yu
- Department of Medical Oncology, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610041, China
| | - Li Ren
- Department of Thoracic Oncology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Youling Gong
- Department of Thoracic Oncology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Wenxiu Yao
- Department of Medical Oncology, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610041, China
| | - Xi Zhang
- Third People's Hospital of Chengdu, Chengdu 610041, China
| | - Jun Yin
- Third People's Hospital of Chengdu, Chengdu 610041, China
| | - Lang He
- Fifth People's Hospital of Chengdu, Chengdu 610041, China
| | - Li Chen
- Hospital of Traditional Medicine of Leshan, Leshan 614000, China
| | - Ke Wang
- Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Meijuan Huang
- Department of Thoracic Oncology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Juan Li
- Department of Medical Oncology, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610041, China
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