Response to lorlatinib on a patient with ALK ‐rearranged non‐small cell lung cancer harboring 1151Tins mutation with uterine metastasis

We describe a case of an anaplastic lymphoma kinase (ALK)‐rearranged non‐small cell lung cancer with development of uterine metastasis after crizotinib and alectinib treatment. Gene analysis from the tissue of uterine metastasis revealed the presence of 1151Tins, which was considered to be a crizotinib and alectinib resistance mutation. Subsequent therapy with the third‐generation ALK inhibitor lorlatinib, but not ceritinib, showed antitumor activity for 1 year. The uterus is an uncommon site for metastasis from lung cancer, and our case indicated that serial gene analysis could provide new information about ALK inhibitor resistance.
A patient with ALK‐rearranged advanced non‐small cell lung cancer presented acquired resistance to alectinib and uterine metastasis. Gene analysis using the tissue from the uterine metastasis revealed the presence of 1151Tins. Lorlatinib showed antitumor activity on this disease for one year.