Long-Term Response of Lorlatinib to Leptomeningeal Metastasis in Patients with Anaplastic Lymphoma Kinase Fusion Positive Non-Small Lung Cancer: A Case Report

Abstract Introduction: Patients with anaplastic lymphoma kinase (ALK)-rearranged non-small cell lung cancer (NSCLC) are at increased risk of central nervous system (CNS) metastasis at initial diagnosis and throughout treatment. In a phase 3 trial, lorlatinib, a third-generation ALK tyrosine kinase i...

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Bibliographic Details
Published in:Case reports in oncology 2024-01, Vol.17 (1), p.942-949
Main Authors: Fujiwara, Yutaka, Masago, Katsuhiro, Matsuzawa, Reiko, Yamaguchi, Teppei, Watanabe, Naohiro, Shimizu, Junichi, Sasaki, Eiichi, Horio, Yoshitsugu
Format: Article
Language:English
Subjects:
anaplastic lymphoma kinase fusion
Brain cancer
Case Report
Case reports
Conflicts of interest
Diplopia
Immunohistochemistry
Kinases
leptomeningeal metastasis
lorlatinib
Lung cancer
Lymphoma
Magnetic resonance imaging
Metastasis
Mutation
non-small cell lung cancer
Patients
Pharmaceuticals
Public speaking
Quality of life
Tomography
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Summary:Abstract Introduction: Patients with anaplastic lymphoma kinase (ALK)-rearranged non-small cell lung cancer (NSCLC) are at increased risk of central nervous system (CNS) metastasis at initial diagnosis and throughout treatment. In a phase 3 trial, lorlatinib, a third-generation ALK tyrosine kinase inhibitor, significantly improved progression-free survival. In further analysis, lorlatinib revealed superior intracranial efficacy and prolonged time to intracranial progression compared with crizotinib. Case Presentation: Herein, we report a case of ALK-positive NSCLC with leptomeningeal metastasis that was successfully treated with lorlatinib after progression to brigatinib and alectinib. This case demonstrates the potential of lorlatinib in managing leptomeningeal metastasis in ALK-positive NSCLC. Conclusion: The case suggests a paradigm shift in therapeutic approaches for CNS metastasis, including brain and leptomeningeal metastases.
ISSN:1662-6575
1662-6575
DOI:10.1159/000540445