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J Thorac Oncol. 2016 Jun;11(6):e67-72. doi: 10.1016/j.jtho.2015.12.105. Epub 2016 Jan 2.

Transformation to SCLC after Treatment with the ALK Inhibitor Alectinib.

Author information

1
Division of Integrated Oncology, Institute of Biomedical Research and Innovation, Kobe, Japan. Electronic address: jp.shirofujita@gmail.com.
2
Division of Integrated Oncology, Institute of Biomedical Research and Innovation, Kobe, Japan.
3
Department of Pathology and Molecular Diagnostics, Aichi Cancer Center Hospital, Nagoya, Japan.

Abstract

We report an anaplastic lymphoma receptor tyrosine kinase gene (ALK)-positive patient who showed a paradoxical response to the ALK inhibitor alectinib; the primary lesion increased in size, whereas other metastatic lesions decreased markedly. A biopsy of the primary lesion confirmed an ALK rearrangement; however, the tumor had transformed histologically into small cell lung cancer. The lack of reports of small cell lung cancer transformation in ALK-positive patients implies that this outcome was unusual; this patient was treated with alectinib, which is more selective and has a greater inhibitory effect than crizotinib. This case may reveal resistance mechanisms that differ according to the agent used for treatment.

PMID:
26751586
DOI:
10.1016/j.jtho.2015.12.105
[Indexed for MEDLINE]
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