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E. Reutova
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P3.02a - Poster Session with Presenters Present (ID 470)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Advanced NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 12/07/2016, 14:30 - 15:45, Hall B (Poster Area)
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P3.02a-031 - Non-Small Cell Lung Cancer Targeted Therapy in Case of ROS1 Rearrangement (ID 5558)
14:30 - 14:30 | Author(s): E. Reutova
- Abstract
Background:
ROS1 gene rearrangement refers to rare genetic aberrations, occurs in 1-2% of patients with NSCLC. of ROS1 rearrangement patient This subgroup of patients is high sensitive to crizotinib therapy.
Methods:
Clinical case Patient, male, 87 y.o., observed in our clinic since July, 2013. Diagnosis: Lung adenocarcinoma , metastases in the both lungs, pleura, supra- and subclavicular lymph nodes, bones, Т3N3М1b, stage IV. EGFR «-», ALK «-». Concomitant diseases: Ischemic heart disease. The heart rhythm disorder (ventricular and supraventricular extrasystole). Treatment performed: 1st line:-Alimta + carboplatin х6 cycles (July - November 2013). Partial response. Disease progression in September 2014. Chemotherapy was proceeded according to the previous regimen. After 4 cycles in February 2015 the further progression of disease was observed. Biopsy of axillar lymph node was performed. Molecular testing found ROS1 gene rearrangement. On 02.04.2015 crisotinib was started with dose reduction 250 mg/day. The next day bradycardia (cardiac rate 39 beats per minute) developed, QTc was prolonged to 558 msec (initially 470 msec). Crizotinib administration was stopped. Development of this adverse event as a rule is the cause of withdrawl of crizotinib. However, high probability of targeted therapy response and absence of alternative in choosing of antineoplastic therapy made us use all the opportunities for correction of adverse events. 10.04.2015 implantation of dual chamber pacemaker was performed and crizotinib 250 mg/day administration was proceeded. The patient’s condition was satisfactory, there were no other adverse events and dose of crizotinib was increased to the standard on 21.04.2015.
Results:
In 7 weeks after beginning of targeted therapy (28.05.2015) PET-CT was performed - local areas of abnormal uptake of FDG were not detected. The patient continues crizotinib at the current time – last PET-CT was done 04.07.2016. Complete response remains. The duration of response is 15 months. Figure 1
Conclusion:
Therefore, we pronounced the early and durable response.
