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Vol.64 No.1 contents | Japanese/English |
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- Case Report -
A Case of Successful Treatment of ROS1-positive Granulocyte Colony-stimulating Factor-producing Lung Adenocarcinoma with an ROS1 Tyrosine Kinase Inhibitor
Yumi Yasui1, Masataka Matsumoto2, Teruaki Hyakudo2, Masahiko Nishii3, Saki Ito2, Masahiro Katsurada2, Yuko Kono2, Kiyonobu Takatsuki2, Yoshihiro Nishimura21Department of Respiratory Medicine, Nishiwaki Municipal Hospital, Japan, 2Department of Respiratory Medicine, Kitaharima Medical Center, Japan, 3Department of Respiratory Medicine, Hyogo Prefectural Awaji Medical Center, Japan
Background. Granulocyte colony-stimulating factor (G-CSF)-producing tumors are known to have a poor prognosis, and the efficacy of ROS1 tyrosine kinase inhibitors (ROS1-TKIs) in treating ROS1 fusion gene-positive G-CSF-producing non-small-cell lung cancer has not been reported. Case. A 56-year-old male patient presented with a rapidly progressing mediastinal tumor and an abnormally high white blood cell count. The diagnosis was lung adenocarcinoma (cTXN3M1c, stage IVB). Serum G-CSF levels were elevated. Due to the rapid progression, we started carboplatin, paclitaxel, bevacizumab, and atezolizumab without awaiting the results of gene mutation testing. However, he experienced progressive disease (PD) after two courses. Subsequently, he was administered cisplatin, pemetrexed, and bevacizumab, but PD occurred again after two courses. After confirming ROS1 fusion gene positivity and starting entrectinib, the dyspnea improved the next day, and 1.5 months later, computed tomography showed shrinkage of the tumor. PD occurred three months after starting entrectinib, and we switched to crizotinib. The tumor shrank rapidly again. Conclusion. ROS1-TKIs may be effective, even for ROS1 fusion gene-positive G-CSF-producing tumors with a poor prognosis.
key words: ROS1, G-CSF-producing tumors, TKI, Lung cancer
Received: August 21, 2023
Accepted: November 28, 2023
JJLC 64 (1): 45-49, 2024
