PDF(Pubmed)
Abstract：
ALK gene rearrangements are detected in approximately 3% to 5% of NSCLC. ALK tyrosine kinase inhibitors, such as third-generation lorlatinib, have exhibited remarkable efficacy in ALK-rearranged NSCLC; however, they have been associated with a low incidence of treatment-limiting and potentially fatal drug-induced interstitial lung disease (ILD). There is concern that this may represent a class effect, a theory that is supported by a number of case reports. Because of clinical trial exclusion criteria, there are limited prospective data to guide decision-making after ALK tyrosine kinase inhibitors-induced ILD. A systematic review of the literature was conducted and only identified four reported cases of lorlatinib safety in this context. Here, we report the successful sequencing of lorlatinib in a patient who discontinued alectinib secondary to grade 3 drug-induced ILD.
摘要：
在约3%至5%的NSCLC中检测到ALK基因重排。ALK酪氨酸激酶抑制剂,例如第三代氯拉替尼，在ALK重排的非小细胞肺癌中表现出显著的疗效；然而，它们与治疗限制性和潜在致命性药物诱发的间质性肺病(ILD)的低发病率相关.有人担心这可能代表了一种阶级效应，许多病例报告支持的理论。由于临床试验排除标准，在ALK酪氨酸激酶抑制剂诱导的ILD后,指导决策的前瞻性数据有限.对文献进行了系统评价，在这种情况下，仅确定了四例报告的氯拉替尼安全性病例。这里,我们报道了1例因3级药物诱导的ILD继发停用alectinib的患者,成功进行了lorlatinib测序.
