Neoadjuvant crizotinib in advanced inflammatory myofibroblastic tumour with ALK gene rearrangement.
BACKGROUND
Inflammatory myofibroblastic tumours (IMTs) are rare sarcomas that were first described in the lung. They are composed of myofibroblastic mesenchymal spindle cells accompanied by an inflammatory infiltrate of plasma cells. Complete resection is the treatment of choice. There is currently no standard treatment for inoperable or recurrent disease. Expression of ALK protein triggered by ALK gene rearrangement at chromosome 2p23 has been found in 36%-60% of IMTs.


METHODS
We report a rapid early response to crizotinib as neoadjuvant therapy, enabling surgical excision of a large ALK-translocated IMT, which resulted in complete disease clearance. To the best of our knowledge, this is the first case in the literature of a patient with IMT in whom crizotinib was used successfully in the neoadjuvant or curative setting.
St. James's Hospital, Dublin - Ireland.
Shereen
S
Rafee
Yasir Y
YY
Elamin
Eimear
E
Joyce
Mary
M
Toner
Richard
R
Flavin
Ronan
R
McDermott
Niall
N
Sheehy
Bryan
B
Hennessy
Kenneth
K
O'Byrne
Noreen
N
Gleeson
Nemer
N
Osman
D000008:Abdominal Neoplasms / Q000175:diagnosis* / Q000188:drug therapy* / Q000235:genetics / Q000473:pathology / Q000601:surgery; D000077548:Anaplastic Lymphoma Kinase; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D000077547:Crizotinib; D003937:Diagnosis, Differential; D005260:Female; D015321:Gene Rearrangement; D006801:Humans; D007249:Inflammation; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000379:methods*; D009379:Neoplasms, Muscle Tissue / Q000175:diagnosis* / Q000188:drug therapy* / Q000235:genetics / Q000473:pathology / Q000601:surgery; D017060:Patient Satisfaction; D049268:Positron-Emission Tomography; D047428:Protein Kinase Inhibitors / Q000627:therapeutic use*; D011720:Pyrazoles / Q000627:therapeutic use*; D011725:Pyridines / Q000627:therapeutic use*; D011788:Quality of Life; D020794:Receptor Protein-Tyrosine Kinases / Q000235:genetics*; D014057:Tomography, X-Ray Computed; D014178:Translocation, Genetic; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D047428:Protein Kinase Inhibitors; D011720:Pyrazoles; D011725:Pyridines; D000077547:Crizotinib; C000626173:ALK protein, human; D000077548:Anaplastic Lymphoma Kinase; D020794:Receptor Protein-Tyrosine Kinases