Complete remission for 4 years with crizotinib in advanced ALK-positive non-small cell lung cancer after thoracostomy for empyema

Tumori. 2019 Dec;105(6):NP35-NP37. doi: 10.1177/0300891619845481. Epub 2019 Apr 26.

Abstract

Introduction: Anaplastic lymphoma kinase (ALK) gene translocation occurs in 3%-5% of patients with non-small cell lung cancer (NSCLC), typically in younger patients. Crizotinib (tyrosine kinase inhibitor) has been considered as the standard of care for advanced ALK-positive lung cancer but it only gives a median progression-free survival of 7.7-11 months.

Case: A 41-year-old old man, former smoker, was diagnosed with NSCLC in the right lung with manifest pleural effusion. This case was complicated by a pleural empyema and because of a trapped lung, there was an indication for the construction of a thoracostomy. After confirmation of the ALK translocation, therapy with crizotinib was started. After 8 weeks, there was excellent response, and 6 months later, all lesions were undetectable on CT scan. There was also complete healing of the thoracostomy wound.

Conclusion: This case describes a relatively young patient with a poor prognosis but with a remarkable and long-term response to crizotinib monotherapy.

Keywords: Non-small cell lung cancer; anaplastic lymphoma kinase; crizotinib; thoracostomy.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anaplastic Lymphoma Kinase / genetics*
  • Carcinoma, Non-Small-Cell Lung / complications
  • Carcinoma, Non-Small-Cell Lung / diagnosis
  • Carcinoma, Non-Small-Cell Lung / drug therapy*
  • Carcinoma, Non-Small-Cell Lung / genetics*
  • Crizotinib / administration & dosage
  • Crizotinib / adverse effects
  • Crizotinib / therapeutic use*
  • Empyema / complications
  • Empyema / diagnosis
  • Empyema / surgery
  • Humans
  • Lung Neoplasms / complications
  • Lung Neoplasms / diagnosis
  • Lung Neoplasms / drug therapy*
  • Lung Neoplasms / genetics*
  • Male
  • Protein Kinase Inhibitors / administration & dosage
  • Protein Kinase Inhibitors / adverse effects
  • Protein Kinase Inhibitors / therapeutic use*
  • Radiography, Thoracic
  • Thoracostomy
  • Tomography, X-Ray Computed
  • Treatment Outcome

Substances

  • Protein Kinase Inhibitors
  • Crizotinib
  • Anaplastic Lymphoma Kinase