Intracranial Response of ALK+ Non-Small-cell Lung Cancer to Second-line Dose-escalated Brigatinib After Alectinib Discontinuation Due to Drug-induced Hepatitis and Relapse After Whole Brain Radiotherapy Followed by Stereotactic Radiosurgery
Edyta Maria Urbanska, Eric Santoni‐Rugiu, Linea Cecilie Melchior, Jonathan Frederik Carlsen, Jens Benn Sørensen
Abstract
Clinical Practice Points•To the best of our knowledge, this is the first report of dose-escalated brigatinib leading to clinical benefit in a patient with multimodal central nervous system-pretreated anaplastic lymphoma kinase-positive non–small-cell lung cancer with isolated progressive brain metastases.•Hepatotoxicity from alectinib is a rare, but potentially insurmountable, impediment for otherwise effective treatment such as the complete intra- and extracranial response in the present case. •To the best of our knowledge, this is the first report of dose-escalated brigatinib leading to clinical benefit in a patient with multimodal central nervous system-pretreated anaplastic lymphoma kinase-positive non–small-cell lung cancer with isolated progressive brain metastases.•Hepatotoxicity from alectinib is a rare, but potentially insurmountable, impediment for otherwise effective treatment such as the complete intra- and extracranial response in the present case.