A 58-Year-Old Woman With ALK+ Non–Small Cell Lung Cancer
Lyudmila Bazhenova, MD, presents the case of a 58-year-old woman with ALK+ non–small cell lung cancer.
Case: A 58-Year-Old Woman With ALK+ NSCLC
Initial presentation
- A 58-year-old woman presented with cough, fatigue and anorexia
- PMH: unremarkable
- PE: unremarkable
Clinical Workup
- Labs: WNL
- Imaging:
- Chest x-ray showed multiple left upper lobe mass and mediastinal lymphadenopathy
- Chest/abdomen/pelvic CT scan confirmed left upper lobe mass measuring 6.2 cm
- PET scan showed PET positivity in bilateral LUL mass and mediastinal LN
- MRI of the brain showed widespread scattered small lesions; consistent with multifocal brain metastases
- Bronchoscopy with transbronchial biopsy of the left upper lobe confirmed lung adenocarcinoma
- Molecular testing: ALK fusion+, EGFR-, ROS1-, BRAF-, KRAS-, NTRK-, MET-, RET-
- Staging: IVA adenocarcinoma; ECOG PS 1
Treatment
- Patient was started on brigatinib 90 mg qDay for 7 days; well tolerated; dose was increased to 180 mg qDay
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