Intra-cranial efficacy of brigatinib in an ALK-positive non-small cell lung cancer patient presenting leptomeningeal carcinomatosis

Elisabeth Gaye; Margaux Geier; Paul Bore; Marine Guilloïque; Francois Lucia; Gilles Quéré; Sylvie Gouva; Gilles Robinet; Renaud Descourt

doi:10.1016/j.lungcan.2019.04.013

Intra-cranial efficacy of brigatinib in an ALK-positive non-small cell lung cancer patient presenting leptomeningeal carcinomatosis

Lung Cancer. 2019 Jul:133:1-3. doi: 10.1016/j.lungcan.2019.04.013. Epub 2019 Apr 20.

Authors

Elisabeth Gaye¹, Margaux Geier², Paul Bore², Marine Guilloïque³, Francois Lucia⁴, Gilles Quéré², Sylvie Gouva², Gilles Robinet², Renaud Descourt²

Affiliations

¹ Medical Oncology Department, University Hospital Morvan, Brest, France. Electronic address: [email protected].
² Medical Oncology Department, University Hospital Morvan, Brest, France.
³ Radiology Department, University Hospital, Morvan, Brest, France.
⁴ Radiotherapy Department, University Hospital Morvan, Brest, France.

PMID: 31200813
DOI: 10.1016/j.lungcan.2019.04.013

Abstract

Objectives: Brigatinib is a second-generation ALK inhibitor which demonstrated activity over crizotinib-resistance, especially on brain metastasis by increased blood-brain penetration. However, its activity on lepto-meningeal disease is unknown and scarcely reported.

Materials and methods: We hereby report the case of lepto-meningeal disease in crizotinib- and ceretinib- treated patient who was successfully treated by brigatinib.

Results: The patient achieved intracranial response to brigatinib more than 14 months.

Conclusion: Our case provides additional data on brigatinib's intracranial activity, not only on brain metastasis but also on leptomeningeal disease, after experiencing resistance to both crizotinib and ceretinib, 1^st and 2^nd generation ALK inhibitors.

Keywords: Brigatinib; Leptomeningeal carcinomatosis; NSCLC; Tyrosine kinase inhibitor.

Publication types

Case Reports

MeSH terms

Adult
Anaplastic Lymphoma Kinase / antagonists & inhibitors
Anaplastic Lymphoma Kinase / genetics
Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
Brain / drug effects*
Brain / pathology
Carcinoma, Non-Small-Cell Lung / drug therapy*
Carcinoma, Non-Small-Cell Lung / mortality
Carcinoma, Non-Small-Cell Lung / secondary
Crizotinib / therapeutic use*
Drug Resistance, Neoplasm
Female
Humans
Lung Neoplasms / drug therapy*
Lung Neoplasms / mortality
Lung Neoplasms / pathology
Male
Meningeal Carcinomatosis / drug therapy*
Meningeal Carcinomatosis / mortality
Meningeal Carcinomatosis / secondary
Middle Aged
Organophosphorus Compounds / therapeutic use*
Pyrimidines / therapeutic use*
Survival Analysis

Substances

Organophosphorus Compounds
Pyrimidines
Crizotinib
Anaplastic Lymphoma Kinase
brigatinib