Clinical Report: Addressing Severe Dysphagia in a 30-Year-Old Female with Advanced ALK-Positive Non-Small Cell Lung Cancer

Overview

This case study presents a 30-year-old woman with severe dysphagia due to advanced ALK-positive non-small cell lung cancer (NSCLC). Administration of lorlatinib via a nasogastric tube resulted in rapid improvement in swallowing and a partial metabolic response.

Background

ALK-positive NSCLC represents a small but significant subset of lung cancers, primarily affecting young, never-smoker patients. The standard treatment involves ALK tyrosine kinase inhibitors (TKIs) like lorlatinib, which have shown efficacy in this population. However, dysphagia can complicate treatment, necessitating alternative administration routes for effective therapy.

Data Highlights

No numerical data or trial data presented in the article.

Key Findings

• A 30-year-old woman with ALK-positive NSCLC presented with severe dysphagia due to lymphadenopathy.
• Lorlatinib was administered via a nasogastric tube after crushing the tablets.
• Rapid reduction in cervical lymph node swelling was observed within days of treatment.
• Imaging two weeks post-treatment showed a partial response, with complete metabolic response noted at six months.
• This case demonstrates the feasibility of enteral administration of lorlatinib in dysphagic patients.

Clinical Implications

The case illustrates a practical approach for administering lorlatinib in patients with dysphagia, ensuring timely access to effective therapy. Clinicians may consider similar strategies for patients unable to swallow oral medications.

Conclusion

Revise to reflect only the outcomes reported in the case without additional conclusions.

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2. Lorlatinib Versus Crizotinib in Patients With Advanced ALK-Positive Non-Small Cell Lung Cancer: 5-Year Outcomes From the Phase III CROWN Study - PubMed, 2024
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7. Therapy for Stage IV Non–Small Cell Lung Cancer With Driver Alterations: ASCO Living Guideline, Version 2025.1 | Journal of Clinical Oncology
8. Lorlatinib Versus Crizotinib in Patients With Advanced ALK-Positive Non-Small Cell Lung Cancer: 5-Year Outcomes From the Phase III CROWN Study - PubMed
9. The Landscape of ALK-Rearranged Non-Small Cell Lung Cancer: A Comprehensive Review of Clinicopathologic, Genomic Characteristics, and Therapeutic Perspectives - PMC