Although the present patient required a double dose reduction during crizotinib treatment, it was possible to continue crizotinib for 71 weeks Abstract Crizotinib, the first clinically available inhibitor of anaplastic lymphoma kinase ALK gene rearrangement, is generally well tolerated. Active EGFR mutations were not identified. A notable difference in the myelotoxicity between crizotinib and alectinib treatment was observed in the present patient. Subgroup analysis by type of chemotherapy showed that median PFS was significantly higher with crizotinib than with either pemetrexed HR: Visual disturbances associated with crizotinib were generally transient and had little or no impact on activities of daily living [ 34 ].
NSCLC is a common cancer and has a very poor prognosis. More on this topic Postchemotherapy resections of residual masses from metastatic non-seminomatous testicular germ cell tumors. Therapeutic use of low-dose corticosteroids to treat neutropenia resulting from crizotinib administration in a patient with anaplastic lymphoma kinase gene translocation-positive lung cancer. Furthermore, this clinical trial confirmed that the incidence of severe neutropenia was higher in the high-dose group than in the low-dose group. Before beginning crizotinib, patients should be warned that visual disturbances may occur and that they might affect activities such as driving in the dark [ 34 ]. Introduction Crizotinib is the first clinically available inhibitor of anaplastic lymphoma kinase ALK gene rearrangement and has shown notable antitumor effects in patients with ALK-positive non-small cell lung cancer NSCLC [ 1 , 2 , 3 ].
Estimated median PFS was 8. At the time of the primary analysis of PROFILEthe intention-to-treat ITT population comprised patients randomised to crizotinib and to chemotherapy who had been followed up for a median of There is evidence that some patients can continue to derive benefit from crizotinib therapy beyond RECIST-defined progression.
Disclosure Statement All authors have no potential conflicts of interest. Eight days later the patient developed severe nausea and vomiting and esophagitis was diagnosed by gastrointestinal endoscopic examination. Currently, strategies aiming to maximize treatment benefit for NSCLC are studh on individualized treatments based on the molecular profile of the disease.
Subsequent evaluation in phase III studies showed that crizotinib improved progression-free survival compared with platinum-based doublet chemotherapy in previously untreated patients and compared with pemetrexed or sfudy in previously treated patients. It is possible that the efficacy of pemetrexed in the present case was associated with ALK positivity. No adjustments have been made to account for differences in the duration of treatment exposure between groups.
Interestingly, patients in the pemetrexed group achieved greater PFS than those in the docetaxel group, consistent with previous studies demonstrating a greater sensitivity to pemetrexed in patients with ALK -positive versus wild-type tumours [ 2829 ]. Treatment is currently focused on individualization according to the molecular profile of the disease.
XALKORI case study
The identification of novel targets for treatment has led to the development of new options that can improve outcomes in selected patients. Sign In or Create an Account. Case report A year-old woman was admitted to our hospital with a left pleural effusion. Patients received crizotinib mg twice daily in day cycles until progression or intolerable adverse events. In this respect, the present case indicates that the appropriate management of AEs is essential to continue crizotinib as long as the patient derives a benefit from this treatment.
The present case also showed that alectinib was effective and well-tolerated as a posttreatment agent after the development of RECIST defined-PD with crizotinib treatment. Median duration of response was N Engl J Med.
Median time to first documented objective response was 7. Additionally, HGF is reportedly produced by bone marrow stromal cells and plays a role in promoting hematopoiesis via the c-Met receptor [ 9 ]. Before beginning crizotinib, patients should be warned that visual disturbances may occur and that they might affect activities such as driving in the dark [ 34 ].
Overall, crizotinib has been shown to provide a valuable first- and second-line treatment option and is now the first-line standard of care for patients with advanced ALK -positive NSCLC. Abstract Crizotinib, the first clinically available inhibitor of anaplastic lymphoma kinase ALK gene rearrangement, is generally well tolerated. In contrast, neutropenia induced by crizotinib is a commonly reported grade 3 or 4 xapkori event.
In the present case, however, neutropenia first developed at 8 weeks and was not observed with rechallenge by dose-reduction of crizotinib.
XALKORI case study | TIGCRU Insight
Activity and safety of crizotinib in patients with ALK-positive non-small-cell lung cancer: Csae for the treatment sgudy ALK-rearranged non-small cell lung cancer: In this case report, the details of the clinical course of a patient with severe neutropenia induced by crizotinib are described.
As a result, there is an unmet clinical need in advanced NSCLC, with potential to improve outcomes by identifying distinct molecular subtypes of patients who may respond to specific targeted therapies.
Crizotinib-treated patients also had significant improvements in individual domains physical, social, emotional and role functioning compared with chemotherapy. The patient underwent 6 cycles of cisplatin, pemetrexed plus bevacizumab, and 12 cycles of maintenance bevacizumab with pemetrexed as first-line therapy.
Crizotinib was also found to result in greater improvements compared with docetaxel for global QoL and all individual domains and compared with pemetrexed for stydy QoL and physical functioning [ 35 ]. For example, one study of platinum-based chemotherapy regimens for advanced NSCLC patients resulted in a median survival of 7. Crizotinib versus chemotherapy in advanced ALK-positive lung cancer.