PMID- 32629718
OWN - NLM
STAT- MEDLINE
DCOM- 20200722
LR  - 20221005
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Print)
IS  - 0025-7974 (Linking)
VI  - 99
IP  - 27
DP  - 2020 Jul 2
TI  - Alectinib in the treatment of ocular metastases of ALK rearranged non small cell 
      lung cancer: Description of 2 case reports.
PG  - e21004
LID - 10.1097/MD.0000000000021004 [doi]
LID - e21004
AB  - RATIONALE: Choroidal metastasis is a rare metastatic location although the most 
      common intraocular neoplasm. In general, choroidal metastases respond favorably 
      to systemic therapy targeted toward the primary neoplasm. In patients with 
      choroidal metastasis of ALK rearranged non small cell lung cancer (NSCLC), 
      targeted therapy using Alk inhibitors gradually replaced radiotherapy as the best 
      treatment. Alectinib is a second-generation ALK inhibitors. Here we describe 2 
      clinical cases of patients with choroidal metastasis of ALK rearranged NSCLC who 
      received Alectinib as first-line therapy achieving disease control and quality of 
      life improvement. PATIENTS CONCERNS: In case report 1, 62-year-old man presented 
      with scintillated scotomas at the level of the right eye; in case report 2, 
      69-year-old man presented with respiratory distress, persistent cough resistant 
      to medical therapy, pain, and blurred vision. DIAGNOSES: In case report 1, fundus 
      and ultrasonographic examination showed circumscribed choroid thickening with 
      dome-like appearance compatible with repetitive lesion. Computed tomographic/y 
      (CT) showed multiple bilateral pulmonary nodular formations and adenocarcinoma of 
      the lung was diagnosed by a transbronchial biopsy.In case report 2, CT showed a 
      primary lesion of 36 x 27 mm in the middle lobe with bilateral lung metastases 
      and lymphadenopathies. Multiple hepatic metastases and minor suspicious bone 
      repetitions. A liver biopsy made a diagnosis of adenocarcinoma compatible with 
      pulmonary primitiveness. An ocular fluoroangiography evidenced a left choroidal 
      metastasis. INTERVENTIONS: Case report 1, 2, medical treatment with Alectinib 
      1200 mg/day was initiated. OUTCOMES: In case report 1, a few days after beginning 
      the treatment, both systemic symptoms like respiratory distress and low vision 
      were palliated. Reassessment by CT confirmed treatment response. In case report 
      2, clinically, visus disorders had already improved 2 weeks after beginning 
      treatment. CT showed pulmonary, nodal, and hepatic response. Stability of bone 
      metastases occurred after 2 months. In addition, ocular ultrasonography 
      documented the regression of previously reported lesions confirmed treatment 
      response. LESSONS: Alectinib works very well in intracranial metastases and is 
      assumed to be so on the ocular ones as well, with benefit for the patient in 
      quality of life.
FAU - Gozzi, Elisa
AU  - Gozzi E
AD  - UOC of Oncology, University of Rome "Sapienza," Aprilia (LT).
FAU - Angelini, Francesco
AU  - Angelini F
AD  - Medical Oncology Unit, Regina Apostolorum Hospital, Albano.
FAU - Rossi, Luigi
AU  - Rossi L
AUID- ORCID: 0000-0003-0635-6780
AD  - UOC of Oncology, University of Rome "Sapienza," Aprilia (LT).
FAU - Leoni, Valentina
AU  - Leoni V
AD  - Medical Oncology Unit, Regina Apostolorum Hospital, Albano.
FAU - Trenta, Patrizia
AU  - Trenta P
AD  - Medical Oncology Unit, Regina Apostolorum Hospital, Albano.
FAU - Cimino, Giuseppe
AU  - Cimino G
AD  - Department of Medical Oncology, Sapienza University of Rome, Medical and Surgical 
      Sciences and Biotechnology.
FAU - Tomao, Silverio
AU  - Tomao S
AD  - Division of Medical Oncology A, Policlinico Umberto I, Sapienza University of 
      Rome, Rome.
AD  - Consorzio Interuniversitario per la Bio-Oncologia (CINBO), Chieti, Italy.
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
RN  - 0 (Carbazoles)
RN  - 0 (Piperidines)
RN  - 0 (Protein Kinase Inhibitors)
RN  - EC 2.7.10.1 (ALK protein, human)
RN  - EC 2.7.10.1 (Anaplastic Lymphoma Kinase)
RN  - LIJ4CT1Z3Y (alectinib)
SB  - IM
MH  - Aged
MH  - Anaplastic Lymphoma Kinase
MH  - Carbazoles/*therapeutic use
MH  - Carcinoma, Non-Small-Cell Lung/drug therapy/*secondary
MH  - Choroid Neoplasms/diagnostic imaging/*drug therapy/pathology/*secondary
MH  - Humans
MH  - Lung Neoplasms/pathology
MH  - Male
MH  - Middle Aged
MH  - Piperidines/*therapeutic use
MH  - Protein Kinase Inhibitors/*therapeutic use
PMC - PMC7337409
COIS- The authors report no conflicts of interest.
EDAT- 2020/07/08 06:00
MHDA- 2020/07/23 06:00
PMCR- 2020/07/02
CRDT- 2020/07/08 06:00
PHST- 2020/07/08 06:00 [entrez]
PHST- 2020/07/08 06:00 [pubmed]
PHST- 2020/07/23 06:00 [medline]
PHST- 2020/07/02 00:00 [pmc-release]
AID - 00005792-202007020-00097 [pii]
AID - MD-D-20-00317 [pii]
AID - 10.1097/MD.0000000000021004 [doi]
PST - ppublish
SO  - Medicine (Baltimore). 2020 Jul 2;99(27):e21004. doi: 10.1097/MD.0000000000021004.