Surgical conversion after anaplastic lymphoma kinase-tyrosine kinase inhibitors (ALK-TKIs) therapy in N3 stage ALK-positive non-small cell lung cancer: a report of three cases
Year: 2026
Type: article
Study design: Case Report
Abstract: Background: -positive NSCLC patients who successfully underwent surgical resection after ALK-TKIs therapy. Case Description: Case 1 was a 45-year-old female who had stable disease (SD) after three cycles of docetaxel plus cisplatin and then received crizotinib 250 mg twice daily for 150 days. Tumor diameter decreased by 81%, and she underwent lobectomy with mediastinal lymph-node dissection. The resected lung lesion and sampled nodes showed pathological complete response (pCR) (0/12 nodes). She did not receive postoperative ALK-TKI therapy and developed an isolated brain metastasis 12 months after surgery; treatment with crizotinib and Gamma Knife radiosurgery achieved subsequent disease control, and the reported overall survival (OS) was 83 months. Cases 2 and 3 were 57- and 51-year-old males, who received alectinib 600 mg twice daily for 225 and 135 days, respectively, and both achieved partial response. They underwent wedge resection and segmentectomy with mediastinal lymph-node dissection. Pathology showed non-major pathological response (non-MPR) with 0/5 involved nodes in Case 2 and pCR with 0/10 involved nodes in Case 3. Both continued postoperative alectinib and were alive without recurrence at the reported 64- and 38-month follow-up points, respectively. Conclusions: -positive NSCLC, surgical resection after induction therapy with ALK-TKIs is a feasible therapeutic strategy. Maintenance ALK-TKIs postoperatively may contribute to favorable long-term survival outcomes.
Authors: Beike Xiao, Hao Guo, Jiatao Zhang, Xue-Ning Yang
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7223332830