Evidence map›Paper›PMID 38924375›Full record

ArticleThoracic cancer2024

Successful intracranial response of lorlatinib after resistance with alectinib and brigatinib in patients with ALK-positive lung adenocarcinoma: Implications of CNS penetration rate of brigatinib.

Yuki Sato, Yoshiharu Sato, Kei Irie, Shigeki Nanjo, Shigeo Hara, Satoru Fujiwara, Keisuke Tomii

Abstract readCase Reports
In one paragraph

Article in Thoracic cancer, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Lorlatinib and neurocognitive adverse events: characterization, risk factors, and the potentially mitigative role of social support.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025
    Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Yuki SatoDepartment of Respiratory Medicine, Kobe City Medical Center General Hospital, Kobe, Japan.ORCID 0000-0002-7829-7524
Yoshiharu SatoDNA Chip Research Inc, Tokyo, Japan.
Kei IrieDepartment of Pharmaceutics, Faculty of Pharmaceutical Science, Kobe Gakuin University, Kobe, Japan.
Shigeki NanjoDepartment of Respiratory Medicine, Kanazawa University Hospital, Kanazawa, Japan.
Shigeo HaraDepartment of Pathology, Kobe City Medical Center General Hospital, Kobe, Japan.
Satoru FujiwaraDepartment of Neurology, Kobe City Medical Center General Hospital, Kobe, Japan.
Keisuke TomiiDepartment of Respiratory Medicine, Kobe City Medical Center General Hospital, Kobe, Japan.

Funding

Kobe City Medical Center General Hospital
6 · The paper itself

Abstract

We present the case of a 34-year-old Japanese man with anaplastic lymphoma kinase (ALK)-positive non-small cell lung cancer and brain metastases. After central nervous system (CNS) disease progression with alecintib and brigatinib, treatment with lorlatinib resulted in a good intracranial response. In this case, we investigated brain penetration ratio of brigatinib using cerebrospinal fluid and paired serum samples, and the ratio was 0.012. Further, we investigated resistance mechanisms via next-generation sequencing (NGS) using lung biopsy at lung cancer diagnosis and brain biopsy sample at progressive disease of brigatinib. No apparent resistance mechanism of known ALK resistance, such as ALK mutations, amplifications, epithelial-mesenchymal transition (EMT) and bypass pathway activation were detected. Taken together, we speculate that the low CNS penetration rate of brigatinib confers CNS progression. Further studies are warranted to reveal the resistance mechanism and propose a treatment strategy for CNS progression in ALK-positive patients.

Indexed as

Adenocarcinoma of LungAminopyridinesAnaplastic Lymphoma KinaseCarbazolesDrug Resistance, NeoplasmLactamsLactams, MacrocyclicLung NeoplasmsOrganophosphorus CompoundsPiperidinesPyrazolesPyrimidinesAdultBrain NeoplasmsHumansMalealectinibALK protein, humanAminopyridinesAnaplastic Lymphoma KinasebrigatinibCarbazolesLactamsLactams, MacrocycliclorlatinibOrganophosphorus CompoundsPiperidinesPyrazolesPyrimidinesALKbrigatinibCNS penetrationlorlatinibnon‐small cell lung cancer

Identifiers

PMID38924375
PMCPMC11320077

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.