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Targeted Therapy With Anaplastic Lymphoma Kinase Inhibitor (Alectinib) in Adolescent Metastatic Non–Small Cell Lung Carcinoma

18F-NaF PET/CT in Response Evaluation

Usmani, Sharjeel MBBS, MS, FEBNM, KBNM^*; Marafi, Fahad KBNM^†; Rasheed, Rashid MBBS, MS^*; Al Maraghy, Muneera KBNM^*; al Kandari, Fareeda KBNM^*

Author Information

From the ^*Department of Nuclear Medicine, Kuwait Cancer Control Center, Khaitan; and

^†Jaber Al-Ahmad Molecular Imaging Center, Shuwaikh, Kuwait.

Received for publication May 15, 2018; revision accepted June 16, 2018.

Conflicts of interest and sources of funding: none declared.

Correspondence to: Sharjeel Usmani, MBBS, MS, FEBNM, KBNM, Department of Nuclear Medicine, Kuwait Cancer Control Center, PO Box 1488, 83001 Khaitan, Kuwait. E-mail: [email protected].

Clinical Nuclear Medicine 43(10):p 752-754, October 2018. | DOI: 10.1097/RLU.0000000000002220

Abstract

Primary lung adenocarcinoma is extremely rare in the pediatric age group. We report an 18-year-old man with non–small cell lung carcinoma stage IV with brain and bone metastatic. Lung biopsy showed expression of PDL1 along with rearrangement of ALK gene at chromosome 2p23. However, neither mutation of ROS1 nor epidermal growth factor receptor overexpression was seen. Second-generation anaplastic lymphoma kinase (ALK) inhibitor (alectinib) is initiated as first line of treatment. After 8 months of treatment with alectinib, ¹⁸F-NaF PET/CT demonstrated resolution of bone lesions. The present case show rapid and good response to alectinib in metastatic ALK-positive non–small cell lung carcinoma.