Comparison of salvage surgeries for lung adenocarcinoma treated with anaplastic lymphoma kinase-tyrosine kinase inhibitors
Introduction: The therapeutic efficacy of anaplastic lymphoma kinase (ALK)-tyrosine kinase inhibitor (TKI) is significant for ALK-rearranged advanced lung cancer. There have been several reports of salvage surgery for advanced lung cancer treated with ALK-TKIs. We report two cases of salvage surgery...
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| Format: | Article |
| Language: | English |
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Elsevier
2021-12-01
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| Series: | Current Problems in Cancer: Case Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666621921000387 |
| _version_ | 1818965566669455360 |
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| author | Naoya Iwamoto Yosuke Matsuura Hironori Ninomiya Ken Uchibori Noriko Yanagitani Kohei Hashimoto Junji Ichinose Masayuki Nakao Sakae Okumura Makoto Nishio Mingyon Mun |
| author_facet | Naoya Iwamoto Yosuke Matsuura Hironori Ninomiya Ken Uchibori Noriko Yanagitani Kohei Hashimoto Junji Ichinose Masayuki Nakao Sakae Okumura Makoto Nishio Mingyon Mun |
| author_sort | Naoya Iwamoto |
| collection | DOAJ |
| description | Introduction: The therapeutic efficacy of anaplastic lymphoma kinase (ALK)-tyrosine kinase inhibitor (TKI) is significant for ALK-rearranged advanced lung cancer. There have been several reports of salvage surgery for advanced lung cancer treated with ALK-TKIs. We report two cases of salvage surgery after treatment with different ALK-TKIs and reviewed the literature. Case 1: A 59-year-old male patient with ALK-rearranged lung adenocarcinoma, clinical-stage ⅣB (T3N2M1c) was treated with alectinib for 18 months. The pulmonary metastasis was enlarged, and lobectomy was performed as a salvage surgery. Although there was a slight adhesion between the hilar lymph nodes and the pulmonary artery, the operation was completed without any problems. The histopathology of the primary lesion revealed pathologic complete response. Case 2: A 45-year-old male patient with ALK-rearranged lung adenocarcinoma, clinical-stage ⅣA (T4N2M1b) was treated with crizotinib for 71 months after chemotherapy. The primary lesion was enlarged, and lobectomy was performed as a salvage surgery. There was severe adhesion between the hilar lymph node and pulmonary artery, which was extremely difficult to dissect. Histopathology of the primary lesion revealed viable tumor cells without degeneration or necrosis, and there was rigid fibrosis between the bronchus and vessels. Conclusion: In previous literature, salvage surgery cases after alectinib administration had better pathologic responses and were easier to perform than surgeries after crizotinib administration. From the two cases and the literature review of this study, various types of ALK-TKIs had different pathologic responses and effects on salvage surgery. Salvage surgery may be considered as a treatment strategy, especially for patients receiving alectinib instead of crizotinib. |
| first_indexed | 2024-12-20T13:19:03Z |
| format | Article |
| id | doaj.art-a00b3e219fa740fc916d0e042b1fa1db |
| institution | Directory Open Access Journal |
| issn | 2666-6219 |
| language | English |
| last_indexed | 2024-12-20T13:19:03Z |
| publishDate | 2021-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Current Problems in Cancer: Case Reports |
| spelling | doaj.art-a00b3e219fa740fc916d0e042b1fa1db2022-12-21T19:39:27ZengElsevierCurrent Problems in Cancer: Case Reports2666-62192021-12-014100089Comparison of salvage surgeries for lung adenocarcinoma treated with anaplastic lymphoma kinase-tyrosine kinase inhibitorsNaoya Iwamoto0Yosuke Matsuura1Hironori Ninomiya2Ken Uchibori3Noriko Yanagitani4Kohei Hashimoto5Junji Ichinose6Masayuki Nakao7Sakae Okumura8Makoto Nishio9Mingyon Mun10Department of Thoracic Surgical Oncology, The Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, JapanDepartment of Thoracic Surgical Oncology, The Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan; Corresponding author.Department of Pathology, The Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan; Division of Pathology, The Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, JapanDepartment of Thoracic Medical Oncology, The Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, JapanDepartment of Thoracic Medical Oncology, The Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, JapanDepartment of Thoracic Surgical Oncology, The Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, JapanDepartment of Thoracic Surgical Oncology, The Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, JapanDepartment of Thoracic Surgical Oncology, The Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, JapanDepartment of Thoracic Surgical Oncology, The Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, JapanDepartment of Thoracic Medical Oncology, The Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, JapanDepartment of Thoracic Surgical Oncology, The Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, JapanIntroduction: The therapeutic efficacy of anaplastic lymphoma kinase (ALK)-tyrosine kinase inhibitor (TKI) is significant for ALK-rearranged advanced lung cancer. There have been several reports of salvage surgery for advanced lung cancer treated with ALK-TKIs. We report two cases of salvage surgery after treatment with different ALK-TKIs and reviewed the literature. Case 1: A 59-year-old male patient with ALK-rearranged lung adenocarcinoma, clinical-stage ⅣB (T3N2M1c) was treated with alectinib for 18 months. The pulmonary metastasis was enlarged, and lobectomy was performed as a salvage surgery. Although there was a slight adhesion between the hilar lymph nodes and the pulmonary artery, the operation was completed without any problems. The histopathology of the primary lesion revealed pathologic complete response. Case 2: A 45-year-old male patient with ALK-rearranged lung adenocarcinoma, clinical-stage ⅣA (T4N2M1b) was treated with crizotinib for 71 months after chemotherapy. The primary lesion was enlarged, and lobectomy was performed as a salvage surgery. There was severe adhesion between the hilar lymph node and pulmonary artery, which was extremely difficult to dissect. Histopathology of the primary lesion revealed viable tumor cells without degeneration or necrosis, and there was rigid fibrosis between the bronchus and vessels. Conclusion: In previous literature, salvage surgery cases after alectinib administration had better pathologic responses and were easier to perform than surgeries after crizotinib administration. From the two cases and the literature review of this study, various types of ALK-TKIs had different pathologic responses and effects on salvage surgery. Salvage surgery may be considered as a treatment strategy, especially for patients receiving alectinib instead of crizotinib.http://www.sciencedirect.com/science/article/pii/S2666621921000387ALK-rearrangementSalvage surgeryTherapeutic efficacy |
| spellingShingle | Naoya Iwamoto Yosuke Matsuura Hironori Ninomiya Ken Uchibori Noriko Yanagitani Kohei Hashimoto Junji Ichinose Masayuki Nakao Sakae Okumura Makoto Nishio Mingyon Mun Comparison of salvage surgeries for lung adenocarcinoma treated with anaplastic lymphoma kinase-tyrosine kinase inhibitors Current Problems in Cancer: Case Reports ALK-rearrangement Salvage surgery Therapeutic efficacy |
| title | Comparison of salvage surgeries for lung adenocarcinoma treated with anaplastic lymphoma kinase-tyrosine kinase inhibitors |
| title_full | Comparison of salvage surgeries for lung adenocarcinoma treated with anaplastic lymphoma kinase-tyrosine kinase inhibitors |
| title_fullStr | Comparison of salvage surgeries for lung adenocarcinoma treated with anaplastic lymphoma kinase-tyrosine kinase inhibitors |
| title_full_unstemmed | Comparison of salvage surgeries for lung adenocarcinoma treated with anaplastic lymphoma kinase-tyrosine kinase inhibitors |
| title_short | Comparison of salvage surgeries for lung adenocarcinoma treated with anaplastic lymphoma kinase-tyrosine kinase inhibitors |
| title_sort | comparison of salvage surgeries for lung adenocarcinoma treated with anaplastic lymphoma kinase tyrosine kinase inhibitors |
| topic | ALK-rearrangement Salvage surgery Therapeutic efficacy |
| url | http://www.sciencedirect.com/science/article/pii/S2666621921000387 |
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