Reference Detail

Ref Type

PMID

(34336591)

Authors

Von CE, Fuang HG

Title

A case of remarkable response to atezolizumab in ALK-translocated metastatic lung adenocarcinoma.

Journal	Vol	Issue	Date	Pages	Journal Short Title
Respiratory medicine case reports	34		2021	101478	Respir Med Case Rep

URL

Abstract Text

The development of resistance to tyrosine kinase inhibitors (TKIs) in metastatic non-small cell lung cancer (NSCLC) with oncogenic driver mutations highlights the challenge in improving the survival of these patients. The standard of care for ALK-rearranged advanced NSCLC refractory to various generations of ALK TKIs falls back to the use of chemotherapy and the prognosis remains poor. We report the case of a 41-year-old lady with an ALK-translocated metastatic lung adenocarcinoma, who demonstrated good response to an immune checkpoint inhibitor, atezolizumab in combination with bevacizumab and chemotherapy (pemetrexed and carboplatin), following disease progression on three generations of ALK TKIs. Six months into treatment, she continues to show improvement in her health-related quality of life and is tolerating treatment well. Our case suggests that this treatment regimen is a potential treatment option for TKI-refractory driver-mutated NSCLC.

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Molecular Profile	Treatment Approach

Gene Name	Source	Synonyms	Protein Domains	Gene Description	Gene Role

Therapy Name	Drugs	Efficacy Evidence	Clinical Trials

Drug Name	Trade Name	Synonyms	Drug Classes	Drug Description

Gene	Variant	Impact	Protein Effect	Variant Description	Associated with drug Resistance

Molecular Profile	Indication/Tumor Type	Response Type	Therapy Name	Approval Status	Evidence Type	Efficacy Evidence	References
ALK rearrange CD274 over exp	lung adenocarcinoma	predicted - sensitive	Atezolizumab + Bevacizumab + Carboplatin + Pemetrexed Disodium	Case Reports/Case Series	Actionable	In a clinical case study, a patient with ALK-rearranged lung adenocarcinoma with high CD274 (PD-L1) expression (TPS>=50%) who progressed on 3 prior ALK inhibitors experienced a rapid and ongoing clinical improvement with the combination therapy of Tecentriq (atezolizumab), Avastin (bevacizumab), Paraplatin (carboplatin), and Alimta (Pemetrexed Disodium), achieving decreased lung lesion size, complete metabolic response of liver lesions, and partial response of bone lesions (PMID: 34336591).	34336591