A Patient With Anaplastic Lymphoma Kinase-Positive Non-Small Cell Lung Cancer With Development of Leptomeningeal Carcinomatosis While on Targeted Treatment With Crizotinib

Leptomeningeal carcinomatosis (LM) is an infrequent, yet morbid and often fatal complication of non–small cell lung cancer (NSCLC). Management of LM is multimodal, often involving systemic chemotherapy, radiotherapy, and a variety of symptom management maneuvers to address elevated intracranial pressure, pain, and mood changes that can accompany the disease. It is increasingly recognized that tumors with actionable mutations in NSCLC, including epidermal growth factor receptor mutations and anaplastic lymphoma kinase (ALK) translocations, respond well to systemic therapy with tyrosine kinase inhibitors yet often progress in the central nervous system. Therefore, more information is needed regarding the natural history and optimal management of LM in specific molecular subtypes of NSCLC. This case report summarizes the management of a patient with ALK-positive NSCLC who developed LM while on targeted treatment with crizotinib within the context of current NCCN Clinical Practice Guidelines in Oncology and recently published studies.

Target Audience

This activity has been designated to meet the educational needs of physicians and nurses involved in the management of patients with cancer.

Learning Objectives

Upon completion of this activity, participants will be able to:

  • Describe the rationale for the management methods used in this case presentation
  • Describe the ideal treatment with anaplastic lymphoma kinase-positive NSCLC with development of leptomeningeal carcinomatosis while on targeted treatment with crizotinib
Additional information
Supporters: 

No commercial support was received for this article.

Course summary
Available credit: 
  • 1.00 Participation
  • 1.00 Nurse
  • 1.00 Physician
Course opens: 
04/11/2013
Course expires: 
04/11/2014
Cost:
$0.00

Jonathan W. Riess, MD
Department of Medicine, Division of Oncology
Stanford Cancer Institute
Stanford University School of Medicine
Stanford, California

Seema Nagpal, MD
Department of Neurology, Division of Neuro-Oncology
Stanford Cancer Institute
Stanford University School of Medicine
Stanford, California

Joel W. Neal, MD, PhD
Department of Medicine, Division of Oncology
Stanford Cancer Institute
Stanford University School of Medicine
Stanford, California

Heather A. Wakelee, MD
Department of Medicine, Division of Oncology
Stanford Cancer Institute
Stanford University School of Medicine
Stanford, California

Available Credit

  • 1.00 Participation
  • 1.00 Nurse
  • 1.00 Physician

Accreditation Period

Course opens: 
04/11/2013
Course expires: 
04/11/2014

Price

Cost:
$0.00
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