Effect of bevacizumab on brain radiation necrosis in anaplastic lymphoma kinase ‐positive lung cancer

We assessed four anaplastic lymphoma kinase (ALK) ‐positive non‐small cell lung cancer (NSCLC) patients who were treated with ALK‐tyrosine kinase inhibitors (TKIs). They developed brain radiation necrosis and brain oedema after stereotactic irradiation. Here, we report the efficacy and safety of bevacizumab given in combination with ALK‐TKI s for brain radiation necrosis in ALK‐positive NSCLC. Central nervous system (CNS) metastases from anaplastic lymphoma kinase (ALK) ‐positive lung cancer often results in failure of ALK‐tyrosine kinase inhibitor (TKI) therapy. Patients with uncontrolled CNS metastases receive radiation therapy, which sometimes causes brain radiation necrosis. We added bevacizumab (15 mg/kg, every 3–4 weeks) to the regimen of four ALK‐p ositive lung cancer patients with brain radiation necrosis who were receiving ALK‐TKI therapy. A decrease in brain radiation necrosis was seen in all the patients, and an improvement in symptoms was seen in three patients. In one patient who was receiving corticosteroid therapy, we could taper the dose and subsequently discontinue it. While one patient discontinued bevacizumab because of adverse events, the other three continued with the treatment. Therefore, the combination of bevacizumab with ALK‐TKI seems to be an effective, manageable, and tolerable treatment for brain radiation necros is.
Source: Respirology Case Reports - Category: Respiratory Medicine Authors: Tags: Case Series Source Type: research