Lung Cancer Research Round Up: January 2020
Case study: Successful re-use of Brigatinib after Lorlatinib
The patient in this case study was diagnosed with ALK-positive lung cancer in 2005 and had disease progression on several occasions. Chemotherapy and radiation were used to treat the first two local progressions to the brain and spinal cord. In 2012, the patient was prescribed Crizotinib for a subsequent recurrence as ALK TKIs were now available. Three years later, another lesion was found in the spinal cord and the patient was put on Brigatinib. The treatment resulted in partial remission. Loratinib and later Alectinib were used for subsequent progressions. Each TKI caused tumor shrinkage at the time. More cerebral lesions were discovered in November 2018. Due to previous radiation in the same area, radiotherapy was no longer an option and chemotherapy was deemed not effective for brain lesions. The patient’s medical team decided to go back to Brigatinib as a treatment option. Rechallenge with a previously used TKI led to partial remission. The patient’s symptoms from brain lesions rapidly diminished while on Brigatinib.
This case study shows that a rechallenge of a previously used TKI can be a valid treatment option, especially if progression is in the central nervous system.