Author of

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  P3.24 - Poster Session 3 - Supportive Care (ID 160)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Supportive Care
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/30/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 12894

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    P3.24-042 - The use experience of crizotinib (XALKORI®) for postoperative recurrence of ALK-rearranged non-small cell lung cancer (ID 2824)

    09:30 - 09:30  |  Author(s): D. Noma
    • Abstract

    Background
    Crizotinib(Xalkori®) was developed as a medicine for anaplastic lymphoma kinase (ALK)-rearranged non-small cell lung cancer (NSCLC). Multi institutes studies established its efficacy and safety for advanced lung carcinoma. After crizotinib release in Japan, there has been no report about usage of crizotinib for postoperative recurrence of lung cancer. We have four patients with postoperative recurrence of ALK-rearranged NSCLC who were treated with crizotinib. We herein report the efficacy and safety of the treatment.

    Methods
    not applicable

    Results
    Case report ALK-rearrangements were confirmed by FISH examination from surgical specimen in　all four patients. Histological diagnoses were pulmonary adenocarcinoma in all cases. Case 1. A 62-year-old man underwent the right middle and lower lobectomy (pT3N2M0) followed by adjuvant chemotherapy with platinum doublet. He had a mediastinum lymph node relapse six months after the operation. Crizotinib was administered as the 2[nd] line. A long stable disease (SD, six months) was obtained in this patient. Case 2. A 62-year-old woman underwent the right upper and middle lobectomy (pT2aN2M1a) followed by adjuvant chemotherapy with platinum doublet. She had multiple lung metastases thirty-one months after the operation. Progressive disease (PD) was detected after four courses of platinum doublet. Crizotinib was administered as the 5[th] line and partial response (PR) was obtained over 5 months. Case 3. A 63-year-old man underwent preoperative chemotherapy followed by the right upper lobectomy (ypT3N2M0). He received an adjuvant chemotherapy with platinum doublet. He developed brain metastases five months after the operation. Crizotinib was administered one month as the 4[th] line, and PR was obtained. Case 4. An 83-year-old woman underwent the left lower lobe wedge resection. (pT2aNXM1a) followed by four regimens of chemotherapy, resulting in PD. Crizotinib was administered as the 5[th] line. The side effects with increase in body weight (+4kg, Grade1), leg edema (Grade 2) and liver dysfunction (Grade 1) deveroped on the 7[th] day. Her symptoms quickly disappeared after discontinue of crizotinib. Another regimen chemotherapy was administered because she rejected restart of the crizotinib treatment.

    Conclusion
    In the efficacies of the crizotinib treatment, two cases were PR, one case was SD and one case was drop out. The crizotinib was effective in two cases which were PD with other regimen treatments. Crizotinib has possibilities of giving dramatic clinical response in ALK-rearranged NSCLC patients. In safeties of the crizotinib treatment, no adverse event was occurred in three cases and Grade 2 adverse in one case. There have been no serious complications.　Crizotinib treatments in ALK-rearranged NSCLC patients have great possibilities of having a clinical benefit. Crizotinib can also be effective and safe in postoperative recurrence of ALK-rearranged NSCLC patients. We reacknowledge an importance of molecular targeted therapy that creates dramatic clinical effects within a short time period. Further observation and accumulation of cases will be necessary to evaluate the clinical effectiveness of this treatment in postoperative recurrence of ALK-rearranged NSCLC patients.