Clinical Response and Safety of Alternating Daily Dosage of Crizotinib due to Side Effects in Advanced NSCLC patient harboring ROS1-rearrangement: A Case Report
DOI:
https://doi.org/10.36497/jri.v43i2.201Keywords:
Crizotinib, NSCLC, ROS1 rearrangementAbstract
Background: Advanced lung cancer has the lowest overall survival than other stage and tyrosine kinase inhibitor (TKI) are promising to prolong life and prevent disease progression. ROS1 rearrangement was very rare and constitute around 1.4 % of all NSCLC. Previous preclinical and clinical trial have reported the efficacy and safety of crizotinib against advanced NSCLC with ROS1 rearrangement, but little is known about its efficacy with nonstandard dosage.
Case: A female, 58 years old, with no history of cancer nor smoking, came with persistent chest pain and cough for three months. The patient was then diagnosed with advanced lung cancer by FDG-PET CT Scan. The biopsy confirmed adenocarcinoma with genotyped ROS1-rearrangement. After receive standar dose of 200 mg bid, the patient intolerated and treatment plan was adjusted with 200 mg of alternated daily dosage (one-day on-off drug administration). Fortunately, the intolerance symptoms were alleviated and showed positive response during 3-years therapy.
Discussion: Pulmonary tuberculosis has been linked to pneumothorax in HIV-associated TB patients. This study is done to better our understanding of the link between the two. The patient had active pulmonary tuberculosis as well as HIV and a rare case of bilateral pneumothorax in the ER.
Conclusion: This case showed that advanced NSCLC with ROS1 rearrangement has positive response to crizotinib despite using alternating daily dose, with good response during 3 years and on.
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References
Dong L, Xia J, Zhang J, Zhang Y, Zhu N, Zhang P, et al. Long-term progression-free survival in an advanced lung adenocarcinoma patient harboring EZR-ROS1 rearrangement: A case report. BMC Pulm Med. 2018;18(1).
Politi K, Herbst RS. Lung cancer in the era of precision medicine. Clin Cancer Res. 2015;21(10):2213–20.
Pavlakis N, Cooper C, John T, Kao S, Klebe S, Lee CK, et al. Australian consensus statement for best practice ROS1 testing in advanced non-small cell lung cancer. Pathology. 2019;51(7):673–80.
Shaw AT, Riely GJ, Bang YJ, Kim DW, Camidge DR, Solomon BJ, et al. Crizotinib in ROS1-rearranged advanced non-small-cell lung cancer (NSCLC): Updated results, including overall survival, from PROFILE 1001. Annals of oncology. 2019;30(7):1121–6.
Lim SM, Kim HR, Lee JS, Lee KH, Lee YG, Min YJ, et al. Open-label, multicenter, phase II study of ceritinib in patients with non-small-cell lung cancer harboring ROS1 rearrangement. Journal of clinical oncology. 2017;35(23):2613–8.
Basit S, Ashraf Z, Lee K, Latif M. First macrocyclic 3rd-generation ALK inhibitor for treatment of ALK/ROS1 cancer: Clinical and designing strategy update of lorlatinib. Eur J Med Chem. 2017;134:348–56.
Christensen JG, Zou HY, Arango ME, Li Q, Lee JH, McDonnell SR, et al. Cytoreductive antitumor activity of PF-2341066, a novel inhibitor of anaplastic lymphoma kinase and c-Met, in experimental models of anaplastic large-cell lymphoma. Mol Cancer Ther. 2007;6(12 Pt 1):3314–22.
Zou HY, Li Q, Lee JH, Arango ME, McDonnell SR, Yamazaki S, et al. An orally available small-molecule inhibitor of c-Met, PF-2341066, exhibits cytoreductive antitumor efficacy through antiproliferative and antiangiogenic mechanisms. Cancer Res. 2007;67(9):4408–17.
Moro-Sibilot D, Cozic N, Pérol M, Mazières J, Otto J, Souquet PJ, et al. Crizotinib in c-MET- or ROS1-positive NSCLC: Results of the AcSé phase II trial. Annals of oncology. 2019;30(12):1985–91.
Xu H, Zhang Q, Liang L, Li J, Liu Z, Li W, et al. Crizotinib vs platinum-based chemotherapy as first-line treatment for advanced non-small cell lung cancer with different ROS1 fusion variants. Cancer Med. 2020;9(10):3328–36.
Michels S, Massutí B, Schildhaus HU, Franklin J, Sebastian M, Felip E, et al. Safety and efficacy of crizotinib in patients with advanced or metastatic ROS1-rearranged lung cancer (EUCROSS): A European phase II clinical trial. Journal of thoracic oncology. 2019;14(7):1266–76.
Wu YL, Yang JCH, Kim DW, Lu S, Zhou J, Seto T, et al. Phase II study of crizotinib in east Asian patients with ROS1-positive advanced non-small-cell lung cancer. Journal of clinical oncology. 2018;36(14):1405–11.
Landi L, Chiari R, Tiseo M, D’Inca F, Dazzi C, Chella A, et al. Crizotinib in MET-Deregulated or ROS1-rearranged pretreated non-small cell lung cancer (METROS): A phase II, prospective, multicenter, two-arms trial. Clinical cancer research. 2019;25(24):7312–9.
Bergethon K, Shaw AT, Ou SHI, Katayama R, Lovly CM, McDonald NT, et al. ROS1 rearrangements define a unique molecular class of lung cancers. Journal of clinical oncology. 2012;30(8):863–70.
Gainor JF, Shaw AT. Novel targets in non-small cell lung cancer: ROS1 and RET fusions. Oncologist. 2013;18(7):865–75.
Mazières J, Rouvière D, D.Milia J, Filleron T, Zalcman G, Biondani P, et al. Crizotinib therapy for advanced lung adenocarcinoma and a ROS1 rearrangement: Results from the EUROS1 cohort. Journal of clinical oncology. 2015;33(9):992–9.
Rothenstein JM, Letarte N. Managing treatment–related adverse events associated with Alk inhibitors. Current Oncology. 2014;21(1):19–26.
Broyles AD, Banerji A, Barmettler S, Biggs CM, Blumenthal K, Brennan PJ, et al. Practical guidance for the evaluation and management of drug hypersensitivity: Specific drugs. J Allergy Clin Immunol Pract. 2020;8(9):S16–116.
Gendarme S, Bylicki O, Chouaid C, Guisier F. ROS-1 fusions in non-small-cell lung cancer: Evidence to date. Current oncology. 2022;29(2):641–58.
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