Response to lorlatinib on a patient with ALK-rearranged non-small cell lung cancer harboring 1151Tins mutation with uterine metastasis

Thorac Cancer. 2021 Aug;12(16):2275-2278. doi: 10.1111/1759-7714.14056. Epub 2021 Jun 28.

Abstract

We describe a case of an anaplastic lymphoma kinase (ALK)-rearranged non-small cell lung cancer with development of uterine metastasis after crizotinib and alectinib treatment. Gene analysis from the tissue of uterine metastasis revealed the presence of 1151Tins, which was considered to be a crizotinib and alectinib resistance mutation. Subsequent therapy with the third-generation ALK inhibitor lorlatinib, but not ceritinib, showed antitumor activity for 1 year. The uterus is an uncommon site for metastasis from lung cancer, and our case indicated that serial gene analysis could provide new information about ALK inhibitor resistance.

Keywords: 1151Tins; ALK; gynecological metastasis; lorlatinib; non-small cell lung cancer.

Publication types

  • Case Reports

MeSH terms

  • Aminopyridines / therapeutic use*
  • Anaplastic Lymphoma Kinase / genetics
  • Antineoplastic Agents / therapeutic use
  • Carbazoles / therapeutic use
  • Carcinoma, Non-Small-Cell Lung / drug therapy*
  • Carcinoma, Non-Small-Cell Lung / genetics
  • Carcinoma, Non-Small-Cell Lung / pathology
  • Crizotinib / therapeutic use
  • Female
  • Gene Rearrangement
  • Humans
  • Lactams / therapeutic use*
  • Lung Neoplasms / drug therapy*
  • Lung Neoplasms / genetics
  • Lung Neoplasms / pathology
  • Middle Aged
  • Mutation
  • Piperidines / therapeutic use
  • Protein Kinase Inhibitors / therapeutic use
  • Pyrazoles / therapeutic use*
  • Uterine Neoplasms / drug therapy*
  • Uterine Neoplasms / genetics
  • Uterine Neoplasms / secondary

Substances

  • Aminopyridines
  • Antineoplastic Agents
  • Carbazoles
  • Lactams
  • Piperidines
  • Protein Kinase Inhibitors
  • Pyrazoles
  • Crizotinib
  • Anaplastic Lymphoma Kinase
  • alectinib
  • lorlatinib