Case report demonstrates pathological complete response following alectinib and salvage surgery in ALK-positive lung adenocarcinoma, suggesting maintenance therapy may prevent late recurrence.
INTRODUCTION: fusion gene-positive non-small cell lung cancer (NSCLC). However, the role of salvage surgery following alectinib for locally advanced disease remains uncertain. CASE PRESENTATION: fusion gene-positive lung adenocarcinoma. She received 1st-line alectinib, achieving a 55.3% reduction in tumor size over 11 months. Subsequent salvage surgery revealed a pathological complete response with no residual tumor cells. During postoperative follow-up off alectinib, recurrence was observed 20 months after surgery, with new brain and pulmonary metastases. Reintroduction of alectinib achieved renewed disease control, and the patient has remained progression-free for 23 months since restarting therapy. CONCLUSIONS: fusion gene-positive NSCLC. Furthermore, it suggests that maintenance ALK-TKI therapy after salvage surgery might be associated with a reduced risk of recurrence. Further studies are warranted to optimize perioperative ALK-targeted strategies.
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Ohta et al. (2025) studied this question.
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