Replacement of ALK inhibitors as an effective strategy for reducing drug toxicity in non-small cell lung cancer patients with ALK gene rearrangement

This case report examines the effects of replacement anaplastic lymphoma kinase inhibitor (ALKi) as a strategy to reduce drug toxicity in patients with non-small cell lung cancer (NSCLC) ALK gene rearrangements. A 61-year-old female patient adenocarcinoma encountered difficulties abnormalities diagnosis: expression abnormal protein was not detected by immunohistochemistry (IHC) assay, but rearrangement present next generation sequencing (NGS) and fluorescence situ hybridization (FISH) assays. The initially treated second-generation ALKi (alectinib). However, experienced severe hepatotoxicity. She successfully switched brigatinib (another inhibitor). During therapy, transient increase creatinine concentration observed, which required dose reduction. Effectiveness both anti-ALK agents observed (partial response treatment, followed disease stabilization). illustrates diagnosing rearrangements possibility replacing inhibitors without compromising treatment efficacy.