A.F. Nasretdinov1, A.V. Sultanbaev1,2, Sh.I. Musin1, K.V. Menshikov1,2, R.T. Ayupov1, G.A. Serebrennikov1, V.E. Askarov1, L.K. Zakirova1, N.I. Sultanbaeva1, A.A. Izmailov1
1Republican Clinical Oncology Dispensary, Ufa
2Bashkir State Medical University, Ufa
Султанбаев Александр Валерьевич ― кандидат медицинских наук, заведующий отделом противоопухолевой лекарственной терапии ГАУЗ «Республиканский клинический онкологический диспансер» МЗ РБ
450054, г. Уфа, пр. Октября, д. 73/1, e-mail: rkodrb@yandex.ru, ORCID ID: 0000-0003-0996-5995
Sultanbaev Aleksandr V. ― Cand. of Sci. (Med.), Head of the Department of anticancer drug therapy of the Republican Clinical Oncology Dispensary
73/1 Oktyabrya Ave., Ufa, 450054, Russian Federation, e-mail: rkodrb@yandex.ru, ORCID ID: 0000-0003-0996-5995
Abstract. There are a significant number of targeted options in the treatment of EGFR and ALK positive cases of non-small cell lung cancer (NSCLC). The situation with targeted therapy for ROS1 positive lung cancer is much more modest. In most regions of Russia, only crizotinib is available, and after progression on it, there are practically no targeted therapy options left. Known ROS1 inhibitors are crizotinib, entrectinib and repotrectinib, which is not available in Russia. The drug lorlatinib is not registered for the treatment of ROS1 positive tumors, but in foreign recommendations it is found as an option for the next line of therapy after progression on the previously mentioned TKIs. In this article, we consider the effectiveness of known ROS1 inhibitors, and also present a clinical case of treating a ROS1 positive patient with lorlatinib as one of the next lines of therapy after crizotinib. The patient underwent 6 lines of therapy sequentially, currently, as of September 2024, the 6th line of therapy remains effective. Lorlatinib in the 5th line showed a partial antitumor response, but only a 5-month progression-free survival (PFS). Lorlatinib toxicity manifested itself in the form of hypercholesterolemia and weight gain, which was an expected spectrum of side effects. No toxicity events in relation to the central nervous system were registered.
Key words: NSCLC, lung cancer, driver mutations, ROS1, crizotinib, entrectinib, lorlatinib.