Post-crizotinib management of effective ceritinib therapy in a patient with ALK-positive non-small cell lung cancer

BMC Cancer. 2016 Aug 2:16:568. doi: 10.1186/s12885-016-2636-z.

Abstract

Background: We report the re-biopsied diagnosis of a patient with anaplastic lymphoma receptor tyrosine kinase (ALK)-positive lung adenocarcinoma successfully treated with ceritinib 450 mg/day taken with food following disease progression and gastrointestinal intolerance to crizotinib.

Case presentation: A 74-year old female patient initially diagnosed with ALK-negative lung adenocarcinoma responded to initial standard chemotherapy. The patient was subsequently re-tested by next generation sequencing (NGS) and found to have ALK EIF2AK3-ALK fusion, and responded to crizotinib, but ultimately progressed and showed intolerance to this ALK inhibitor. She was then successfully treated with ceritinib 450 mg/day taken with food, has not suffered from any further gastrointestinal side-effects, and remains on ceritinib treatment after 12 months.

Conclusions: Second-line ceritinib treatment, when administered at 450 mg/day with food, is both well tolerated and efficacious in a patient with previously treated lung adenocarcinoma who had discontinued crizotinib due to disease progression and gastrointestinal adverse effects (AEs).

Keywords: ALK-positive NSCLC; Case report; Ceritinib; Dose; Gastrointestinal tolerance.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Anaplastic Lymphoma Kinase
  • Carcinoma, Non-Small-Cell Lung / drug therapy*
  • Carcinoma, Non-Small-Cell Lung / genetics
  • Crizotinib
  • Female
  • Gene Fusion
  • High-Throughput Nucleotide Sequencing
  • Humans
  • Lung Neoplasms / drug therapy*
  • Lung Neoplasms / genetics
  • Pyrazoles / administration & dosage
  • Pyrazoles / therapeutic use
  • Pyridines / administration & dosage
  • Pyridines / therapeutic use
  • Pyrimidines / administration & dosage*
  • Pyrimidines / therapeutic use
  • Receptor Protein-Tyrosine Kinases / genetics*
  • Sulfones / administration & dosage*
  • Sulfones / therapeutic use
  • Treatment Outcome
  • eIF-2 Kinase / genetics*

Substances

  • Pyrazoles
  • Pyridines
  • Pyrimidines
  • Sulfones
  • Crizotinib
  • ALK protein, human
  • Anaplastic Lymphoma Kinase
  • Receptor Protein-Tyrosine Kinases
  • EIF2AK3 protein, human
  • eIF-2 Kinase
  • ceritinib