Rapid Response to Lorlatinib in a Patient With TFG-ROS1 Fusion Positive Inflammatory Myofibroblastic Tumor of the Chest Wall Metastatic to the Brain and Refractory to First and Second Generation ROS1 Inhibitors
Benjamin Carcamo, Ranjan Bista, Harry Wilson, Prasanth Reddy, Jose M. Pacheco
Abstract
Most inflammatory myofibroblastic tumors (IMTs) harbor ALK fusions but oncogene fusions involving ROS1, RET, NTRK, and PDGFR also occur. The recognition that most IMTs harbor receptor tyrosine kinase fusions has provided a rationale for the use of tyrosine kinase inhibitors to target these oncogenic drivers in advanced IMTs. Crizotinib has been effective in ALK and ROS1-positive IMTs but resistance eventually develops. Here we report the successful use of lorlatinib in a patient with heavily pretreated ROS1-positive IMT of the chest wall with acquired crizotinib-resistance and metastasis to the brain.
Topics & Concepts
CrizotinibROS1MedicineTyrosine kinaseRefractory (planetary science)Cancer researchReceptor tyrosine kinaseAcquired resistanceOncogeneBrain metastasisAnaplastic lymphoma kinaseMetastasisPathologyInternal medicineReceptorCancerAdenocarcinomaLung cancerBiologyMalignant pleural effusionAstrobiologyCell cycleIgG4-Related and Inflammatory DiseasesNeuroendocrine Tumor Research AdvancesSoft tissue tumor case studies