It is possible that the efficacy of pemetrexed in the present case was associated with ALK positivity. However, 1 year after the start of clinical trials, ALK was recognised as a molecular target in NSCLC [ 7 , 11 , 16 ] and shortly afterwards a diagnostic assay was developed to screen for ALK -positive patients [ 16 ], allowing crizotinib to be evaluated in this population. In the present case, crizotinib was used as a fourth-line therapy and a therapeutic effect was achieved. National Center for Biotechnology Information , U. A potential rationale for this observation is that ALK -positive tumours may express lower levels of thymidylate synthase than ALK -negative tumours [ 30 ]. A Chest computed tomography CT at diagnosis revealed multiple pulmonary nodules in the left upper lobe and a pleural effusion. Furthermore, at the time of writing, in post-marketing surveillance in Japan 8 , three cases of esophageal ulcers and six of esophagitis caused by crizotinib were reported; among these nine cases, three were severe.
Immune-mediated neutropenia often occurs within days to a few weeks after beginning the drug, and drug rechallenge, even at low doses, is characteristically associated with prompt recurrence of neutropenia [ 12 ]. Sign In or Create an Account. The most frequently occurring treatment-related adverse events are visual disturbances, gastrointestinal events nausea, diarrhea, vomiting and constipation and peripheral edema 3 , 4. It furthers the University’s objective of excellence in research, scholarship, and education by publishing worldwide. Comparison of four chemotherapy regimens for advanced non-small-cell lung cancer. In such cases, interruption and dose reduction of crizotinib might be necessary for some patients with severe neutropenia. After discontinuation, improvement of neutropenia neutrophil count:
XALKORI case study | TIGCRU Insight
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 Casse study. A Case Report and Review of the Literature. However, this resulted in a similar severity of neutropenia neutrophil count: More on this topic Postchemotherapy resections of residual masses from metastatic non-seminomatous testicular germ cell tumors. A novel, highly sensitive antibody allows for the routine detection of ALK-rearranged lung adenocarcinomas by standard immunohistochemistry.
Patients received crizotinib mg twice daily in day cycles until progression or intolerable adverse events. A correction has been published: Citing articles via Web of Science In this case, the patient exhibited an eminently cawe response to pemetrexed, which preceded crizotinib treatment.
Clinicians should be aware that treatment with crizotinib may result in severe esophagitis. However, the patient relapsed with bone metastasis of the 10th thoracic vertebra and elevation of serum carcinoembryonic antigen CEA levels from 3. Here we present the case of a year-old patient who presented with multiple pulmonary nodules, a left pleural effusion and an ovarian tumor.
Clinicians should be aware that crizotinib therapy may result in severe esophagitis. 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 ].
The ALK inhibitor ceritinib overcomes crizotinib resistance in non-small cell lung cancer. However, 1 year after the start of clinical trials, ALK was recognised as a molecular target in NSCLC [ 71116 ] and shortly afterwards a diagnostic assay was developed to screen for ALK -positive xwlkori [ 16 ], allowing crizotinib to be evaluated in this population. Eight days later, the patient was unable to eat or drink.
XALKORI case study
Following the interruption of crizotinib treatment by treatment with a proton pump inhibitor PPIcrizotinib treatment was re-initiated and was xalkodi for a minimum of 6 months.
This article has been cited by other articles in PMC. Gastrointestinal adverse events were common in crizotinib studies but were generally mild or moderate and could usually be managed with supportive care rather than dose reduction or interruption [ 34 ].
Clinical course after administration of crizotinib. Several ALK inhibitors have been introduced in clinical trials or are currently under preclinical development. Median PFS was significantly higher with crizotinib 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 xtudy effective inhibitor for sequential treatment.
In both phase III studies, most adverse events were of grade 1 or 2 severity [ 2627 ]. Case report A year-old woman was admitted to our hospital with a left pleural effusion. Crizotinib is the first clinically available inhibitor of anaplastic lymphoma kinase ALK gene rearrangement and has shown notable antitumor effects in patients with ALK-positive non-small cell lung cancer NSCLC [ 123 ].
In the present case, crizotinib was used as a fourth-line therapy and a therapeutic effect was achieved. Author information Copyright and License information Disclaimer.
As of this writing, she has continued this treatment for 12 weeks and has shown no evidence of neutropenia or disease progression. Crizotinib should, however, be discontinued if treatment-related pneumonitis occurs and standard treatments for ILD should be considered [ 34 ].
Esophagitis should be recognized as a potential adverse event of crizotinib treatment and, if diagnosed, early treatment with PPI may aid in the continuation of crizotinib treatment.