Durable response to alectinib in a patient with advanced alk-positive non-small cell lung cancer: A case report

Non-small cell lung cancer (NSCLC) is the leading cause of cancer-related morbidity and mortality worldwide. The discovery of anaplastic lymphoma kinase (ALK) gene translocations and the subsequent development of targeted therapies have transformed the prognosis for patients with advanced ALK-positive NSCLC accounting for about 3–7% of all NSCLC cases. With the introduction of targeted drugs, particularly tyrosine kinase inhibitors, treatment strategies for these patients have fundamentally changed. Alectinib, a second-generation tyrosine kinase inhibitor, has demonstrated high efficacy and improved progression-free survival as first-line therapy for ALK-positive NSCLC. This article presents a clinical case of a durable response to alectinib in a 43-year-old female patient with advanced ALK-positive lung adenocarcinoma with metastases to the lungs, pleura, and liver. First-line treatment with alectinib resulted in rapid and profound regression of tumor lesions, achieving a complete radiological response that has been maintained for 4 years. The therapy was characterized by a manageable safety profile. This observation demonstrates the potential for achieving long-term disease control and converting advanced ALK-positive NSCLC into a chronic, manageable condition with the use of alectinib as first-line therapy.