PMC9214311_01
First-line treatment with alectinib in a 37-year-old patient with a metastatic ALK-rearranged LCNEC. (A) FDG-PET scan, whole-body overview, before (left) and 12 weeks after (right) initiation of first-line treatment with alectinib. (B) Complete response of the multiple brain metastases 10 weeks after the start of alectinib. Whole-brain radiation could be avoided. Red arrow shows excellent tumor response under treatment with alectinib.
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The patient started first-line treatment with alectinib, showing good clinical and radiographical partial response of the brain metastases already 4 weeks after treatment initiation (Figures 3A, B).
PMC9214311_02
Complete metabolic and subtotal morphologic response to molecularly targeted treatment with alectinib in a 32-year-old patient diagnosed with a metastatic ALK-rearranged LCNEC. (A) FDG-PET scan, whole-body overview, before initiation of first-line treatment with alectinib. No metabolic or morphological response had been observed after one cycle of platin-based chemotherapy administered before obtaining the results of tumor molecular profiling showing ALK rearrangement. (B) FDG-PET scan performed 8 weeks after treatment start with alectinib showing complete metabolic and subtotal morphological response of the primary tumor and the lymph node metastases (blue arrows).
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The patient showed a rapid excellent tumor response to alectinib, with complete metabolic remission at all metastatic sites 6 weeks after treatment initiation (Figure 4).
PMC9214311_03