Rapid response in a critical lung adenocarcinoma presenting as large airway stenoses after receiving stent implantation and sequential rebiopsy guided ALK inhibitor therapy: a case report

Airway stent implantation can improve the symptoms of airway stenosis caused by a malignant tumor immediately. However, stent implantation is only a palliative therapy and disease will quickly progress without subsequent treatment. Targeted therapy can provide accurate etiological treatment for patients with critical lung cancer who cannot receive chemotherapies. In our clinic, we encountered a 50-year-old male presenting with stage IV lung adenocarcinoma. He failed both the first-line and second-line chemotherapies and suffered severe complex left and right main bronchial stenoses caused by tumor invasion. An emergency stent was implanted to relieve dyspnea symptoms. At nearly the same time, he was detected to have an ALK gene fusion mutation upon rebiopsy and subsequently began crizotinib therapy. A short time later his obstructed airway returned to normal and lesions in the lung were miraculously reduced. This case indicates that the combination of stent implantation and real-time rebiopsy guided targeted therapy brings a new hope for patients with critical lung cancer.