title: Post-crizotinib management of effective ceritinib therapy in a patient with ALK-positive non-small cell lung cancer.
abstract: We report the re-biopsied diagnosis of a patient with anaplastic lymphoma receptor tyrosine kinase (ALK)-positive lung adenocarcinoma successfully treated with ceritinib 450 mg/day taken with food following disease progression and gastrointestinal intolerance to crizotinib.
  
  
  
  A 74-year old female patient initially diagnosed with ALK-negative lung adenocarcinoma responded to initial standard chemotherapy. The patient was subsequently re-tested by next generation sequencing (NGS) and found to have ALK EIF2AK3-ALK fusion, and responded to crizotinib, but ultimately progressed and showed intolerance to this ALK inhibitor. She was then successfully treated with ceritinib 450 mg/day taken with food, has not suffered from any further gastrointestinal side-effects, and remains on ceritinib treatment after 12 months.
  
  
  
  Second-line ceritinib treatment, when administered at 450 mg/day with food, is both well tolerated and efficacious in a patient with previously treated lung adenocarcinoma who had discontinued crizotinib due to disease progression and gastrointestinal adverse effects (AEs).
authors.affiliation: Section of Hematology/Oncology, University of Chicago, 5841 South Maryland Avenue, MC 2115, Chicago, IL, 60637, USA.
authors.forename: Brian
authors.initials: B
authors.lastname: Won
authors.affiliation: Current address, Department of Medical Oncology and Therapeutics Research, City of Hope, 1500 E Duarte Rd, Duarte, CA, 91010-3000, USA.
authors.forename: Isa
authors.initials: I
authors.lastname: Mambetsariev
authors.affiliation: Current address, Department of Medical Oncology and Therapeutics Research, City of Hope, 1500 E Duarte Rd, Duarte, CA, 91010-3000, USA. rsalgia@coh.org.
authors.forename: Ravi
authors.identifier: 0000-0001-9643-7626
authors.initials: R
authors.lastname: Salgia
mesh_terms: D000368:Aged; D000077548:Anaplastic Lymphoma Kinase; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000235:genetics; D000077547:Crizotinib; D005260:Female; D050939:Gene Fusion; D059014:High-Throughput Nucleotide Sequencing; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000235:genetics; D011720:Pyrazoles / Q000008:administration & dosage / Q000627:therapeutic use; D011725:Pyridines / Q000008:administration & dosage / Q000627:therapeutic use; D011743:Pyrimidines / Q000008:administration & dosage* / Q000627:therapeutic use; D020794:Receptor Protein-Tyrosine Kinases / Q000235:genetics*; D013450:Sulfones / Q000008:administration & dosage* / Q000627:therapeutic use; D016896:Treatment Outcome; D019892:eIF-2 Kinase / Q000235:genetics*
chemical_list: D011720:Pyrazoles; D011725:Pyridines; D011743:Pyrimidines; D013450:Sulfones; D000077547:Crizotinib; C000626173:ALK protein, human; D000077548:Anaplastic Lymphoma Kinase; D020794:Receptor Protein-Tyrosine Kinases; C460640:EIF2AK3 protein, human; D019892:eIF-2 Kinase; C586847:ceritinib
keywords: ALK-positive NSCLC; Case report; Ceritinib; Dose; Gastrointestinal tolerance