Treatment of brain metastases in ALK-positive Non-Small Cell Lung Cancer

Brain metastases are quite frequent in patients with ALK-translocated non-small cell lung cancer (NSCLC): they are often not amenable to surgical resection and are generally treated with radiotherapy (RT). This however causes severe late toxic side effects that may become invalidating considering the relatively long survival provided by recent medical treatment with target therapies. Several clinical trials have demonstrated that ALK-inhibitors (crizotinib, alectinib, brigatinib) show excellent activity also against brain metastases. It is therefore reasonable, in asymptomatic patients, to start treatment with specific inhibitors: RT will be used at the time of tumor progression or when symptoms appear. This sequence provides the best quality of life for patients. READ ARTICLE

Critical Reviews in Oncology/Hematology DOI: 10.1016/j.critrevonc.2021.103400

Authors: Serena Ceddia and Giovanni Codacci-Pisanelli

Review Paper, group5Kirk SmithJune 1, 2021brain metastases, ALK-translocation, crizotinib, alectinib, lorlatinib, brigatinib

ALK-rearranged lung adenocarcinoma transformation into high-grade large cell neuroendocrine carcinoma: Clinical and molecular description of two cases

Highlights: • First two cases of ALK-rearranged LUAD that transformed to high-grade LCNEC after ALK-TKI treatment. • Development of on-target ALK G1202R mutation, showing unique dual mechanisms of resistance in both cases. • Different RB1 status in both cases, with worse outcome in the case with RB1 loss. READ ARTICLE

Lung Cancer DOI:10.1016/j.lungcan.2020.06.005

Authors: Aline F. Fares, Benjamin H. Lok, Tong Zhang, Michael Cabanero, Sally C. M. Lau, Tracy Stockley, Devalben Patel, Penelope A. Bradbury, Adrian Sacher, Kazuhiro Yasufuku, Barbara A. Morash, Peter J. B. Sabatini, Lananhn N. Nguyen, Natasha B. Leighl, Ming-Sound Tsao, Frances A. Shepherd, Geoffrey Liu, Sebastiao N. Martins-Filho, Prodipto Pal

Case StudyKirk SmithAugust 1, 2020ALK-translocation, Large-cell-neuroendocrine-carcinoma, Histologic-transformation