Effective Crizotinib schedule for an elderly patient with ALK rearranged non-small-cell lung cancer: a case report.
Effective Crizotinib schedule for an elderly patient with ALK rearranged non-small-cell lung cancer: a case report.
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克唑替尼治疗老年 ALK 重排非小细胞肺癌患者的有效方案：病例报告。
DOI：
10.1186/s13104-015-1126-8
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发表时间：
2015-04-23
影响因子：
1.8
通讯作者：
Gemma A
中科院分区：
文献类型：
--
作者：
Fukuizumi A;Miyanaga A;Seike M;Kato Y;Nakamichi S;Chubachi K;Matsumoto M;Noro R;Minegishi Y;Kunugi S;Kubota K;Gemma A
具有间变性淋巴瘤激酶（ALK）易位的非小细胞肺癌（NSCLC）对小分子ALK激酶抑制剂（如克唑替尼）高度敏感。我们报告一例81岁男性肺腺癌术后局部复发。他接受了放疗和多西他赛化疗，但两种治疗方案均无效。确定ALK重排后，开始克唑替尼治疗。克唑替尼治疗5天后，发生急性肾衰竭（2级/CTCAE ver4.0）和充血性心力衰竭（3级）等不良事件。需要克唑替尼改良治疗。半剂量克唑替尼治疗不能控制肿瘤进展。最终，克唑替尼以250 mg的剂量给药，每日两次，每3天给药一次，持续13个月，维持抗肿瘤作用。这是第一例病例报告，在发生严重不良事件的ALK重排NSCLC患者中，克唑替尼给药时，跳跃方案比每日减量更有效。
Non-small-cell lung cancers (NSCLCs) harboring translocations in anaplastic lymphoma kinase (ALK) are highly sensitive to small-molecule ALK kinase inhibitors, such as crizotinib. We describe a case of post-operative local recurrence of lung adenocarcinoma in an 81 year-old male. He underwent radiation and received chemotherapy with docetaxel, but neither treatment regimen was effective. Following identification of ALK rearrangements, crizotinib treatment was initiated. After treatment with crizotinib for 5 days, adverse events including acute renal failure (grade 2/CTCAE ver4.0) and congestive heart failure (grade 3) occurred. Crizotinib modified treatment was required. Half dose of crizotinib treatment could not control tumor progression. Ultimately, crizotinib was administrated at a dose of 250 mg twice daily every 3 day dosing for 13 months with maintenance of the anti-tumor effect. This is the first case report that skip schedule was more effective than dose reduction daily in crizotinib administration for ALK rearranged NSCLC patient with severe adverse events.