EXCELLENT RESPONSE TO ALECTINIB IN ALK-POSITIVE NSCLC ADENOCARCINOMA-A CASE REPORT AND LITERATURE REVIEW
Abstract
Non small cell lung carcinoma (NSCLC) is a type of lung carcinoma that slowly grows within the lung
tissue, thus it is often diagnosed lately when the disease has already progressed and passed to other
body organs and/or lymph nodes. This makes NSCLC in most of the cases inoperable at the exact
moment of diagnosing, which leads to a necessity of using a chemotherapy that has the purpose of
narrowing the extended masses in the lungs and/or near/further metastases. Alectinib is a tyrosine-
kinase inhibitor (TKI) that is currently being used as a first line target therapy in treating the
inoperable ALK rearranged NSCLC, but still the effectiveness of the treatment is not definitely known
and examined. Herein, we report a case of a 51-year-old male patient presented to our hospital with
hemoptysis for 2 weeks. Contrast-enhanced computerized tomography (CT) of the chest showed an
approximately 28x23 mm soft tissue mass infiltrating into the lumen of the right bronchus and causing
obstruction. On the same side at the base, a hypodense nodule of 19 mm with some surrounding
pneumonic reaction and irregular contours was detected. Several significant lymph nodes were detected
in the hilar and mediastinal regions. Transobronchial biopsy of the mass showed pulmonary
adenocarcinoma and immunohistochemical testing results confirmed ALK rearrangements. TKI
alectinib was given at a dosage of 600mg twice per day for 13 cycles, achieving a complete response of
the disease with complete regression of the mass in the right bronchus, complete regression of the right
nodule and hilar and mediastinal lymph nodes were not detected after treatment . The patient
continued to receive alectinib and did not report any specific discomfort at his 13 month follow-up.
Keywords: NSCLC, Lung adenocarcinoma, ALK rearrangement, TKIs, Alectinib
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