Open AccessDramatic response to alectinib in an ALK ‐positive LCNEC patient with a poor performance status: A case report
Author(s) -
Masuda Kazuki,
Saiki Masafumi,
Shimamura So,
Ide Shuichiro,
Uchida Yoshinori,
Sogami Yusuke,
Ishihara Hiroshi,
Ikeda Fumi,
Kugiyama Kiyotaka
Publication year - 2021
Publication title -
respirology case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.304
H-Index - 9
ISSN - 2051-3380
DOI - 10.1002/rcr2.817
Subject(s) - alectinib , anaplastic lymphoma kinase , medicine , lung cancer , fusion gene , oncology , cancer research , mutation , adenocarcinoma , gene , cancer , biology , genetics , malignant pleural effusion
The echinoderm microtubule‐associated protein‐like 4 ( EML4 )–anaplastic lymphoma kinase ( ALK ) fusion gene, a driver mutation in lung carcinoma, is fairly common in lung adenocarcinoma but rare in large cell neuroendocrine carcinoma (LCNEC). Here we report a case of stage IV LCNEC positive for this fusion gene in a patient with a poor performance status (PS) who was effectively treated with alectinib. The patient was a 72‐year‐old non‐smoking man diagnosed as LCNEC with multiple metastases. Because of his poor PS, cytotoxic chemotherapy was not indicated, but he was later found to be positive for the ALK fusion gene and treated with alectinib as first‐line therapy. One month later, the tumour had shrunk remarkably, and the therapeutic effect was rated as a partial response. The PS also improved from 4 to 1. Investigating actionable driver mutations seems worth doing for advanced LCNEC, especially if the patient's PS is poor.