Therapeutic use of low-dose corticosteroids to treat neutropenia resulting from crizotinib administration in a patient with anaplastic lymphoma kinase gene translocation-positive lung cancer. Patients receiving chemotherapy were permitted to cross over to crizotinib after progression. Email alerts New issue alert. However, there are currently few reports of detailed clinical experience and management of severe neutropenia in these patients. In the present case, crizotinib treatment was re-initiated following a brief interruption and the initiation of PPI therapy. ALK inhibitors vary in their potency against different ALK kinase domain mutations [ 41 — 44 ]; therefore, re-biopsy at the time of disease progression may provide valuable information about the most effective inhibitor for sequential treatment.
Two months after the initiation of crizotinib treatment the CEA levels decreased to 3. Directors of Clinical Research programs: Crizotinib is generally well tolerated, because the severity of its most common adverse events AEs , such as visual disturbance, nausea, diarrhea, constipation, vomiting, and peripheral edema, is grade 1 or 2 [ 1 , 2 , 3 ]. Anaplastic lymphoma kinase gene rearrangements in non-small cell lung cancer are associated with prolonged progression-free survival on pemetrexed. In this case, the patient exhibited an eminently prolonged response to pemetrexed, which preceded crizotinib treatment.
XALKORI case study | TIGCRU Insight
Thereafter, ALK analysis was performed on the formalin-fixed, paraffin-embedded section from the previous surgical procedure; anti-ALK immunohistochemistry with the intercalated antibody-enhanced polymer method was positive, and EML4-ALK gene fusion was positive by fluorescence in situ hybridization. Author information Article notes Copyright and License information Disclaimer.
Interestingly, patients in the pemetrexed group achieved greater PFS than those in the docetaxel group, consistent with previous studies demonstrating a greater sensitivity to pemetrexed in patients with ALK -positive versus wild-type tumours [ 2829 ].
Subgroup analysis by xlakori of chemotherapy showed that median PFS was significantly higher with crizotinib than with either pemetrexed HR: Esophagitis has not been reported as a major crizotinib-related adverse event in previous studies, although three cases of esophagitis two cases of grade 1 and one of grade 2 were reported among patients in phase I and II trials 7.
Median duration of response was Close mobile search navigation Article navigation. cas
Physicians should also be aware that QTc prolongation may be more likely to occur in individuals with electrolyte disturbances secondary to vomiting, diarrhoea or impaired renal function.
Further research is required to optimise the management of progression within the CNS, including evaluation of second-generation Zalkori inhibitors such as ceritinib, alectinib, brigatinib and lorlatinib, which have demonstrated intracranial activity [ 33 ].
Comparison of four chemotherapy regimens for advanced non-small-cell lung cancer. Survival benefit of pemetrexed in lung adenocarcinoma patients with anaplastic lymphoma kinase gene rearrangements.
Anaplastic lymphoma kinase inhibition in non-small-cell lung cancer.
XALKORI case study
Safety and activity of alectinib against systemic disease and brain metastases in patients with crizotinib-resistant ALK-rearranged non-small-cell lung cancer AFJG: Targeted therapy in non-small-cell lung cancer – is xalklri becoming a acse Following the interruption of crizotinib treatment by treatment with a proton pump inhibitor PPIcrizotinib treatment was re-initiated and was effective for a minimum of 6 months.
The patient underwent 6 cycles of cisplatin, pemetrexed plus bevacizumab, and 12 cycles of maintenance bevacizumab with pemetrexed as first-line therapy.
A potential rationale for this observation is that ALK -positive tumours may express lower levels of thymidylate synthase than ALK -negative tumours [ 30 ]. Non-small-cell lung cancer NSCLC is the most commonly diagnosed type of cancer and is a leading cause of cancer-related mortality worldwide 1. In both phase III studies, most adverse events were of grade 1 or 2 severity [ 2627 ].
Crizotinib-treated patients also had significant improvements in individual domains physical, social, emotional and role functioning compared with chemotherapy. Email alerts New issue alert. There was no recurrence of the esophageal symptoms. Non-small-cell lung cancer NSCLC is associated with a poor prognosis sttudy low survival rates, providing a strong rationale for the development of new treatment options.
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This is illustrated xase a recent report of sequential ALK inhibitor therapy that demonstrates the utility of re-biopsy in providing patients with a personalised treatment sequence [ 45 ].
With regard to the adverse effects, crizotinib was demonstrated to be tolerable 34. The discovery of hepatocyte growth factor HGF and its significance for cell biology, life sciences and clinical medicine.
This treatment was continued for 36 months 34 cycles Fig. NR, not reported i.
Nakamura T, Mizuno S. Activity and safety of crizotinib in patients with ALK-positive non-small-cell lung cancer: Therefore, we reasoned that the severe neutropenia was attributable to crizotinib, which was discontinued again. A randomised phase II study investigating durvalumab in addition to an anthracycline taxane-based neoadjuvant therapy in early triple negative breast cancer — clinical results and biomarker analysis of GeparNuevo study.
Since re-examination of biopsies is usually not feasible in advanced NSCLC patients, this is of clinical significance. Published online Sep