Faculty of Medicine
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Item type:Publication, BRAIN METASTASIS FROM LUNG CANCER(Македонско лекарско друштво = Macedonian medical association, 2025-04); ; Lung cancer is the leading cause of global cancer incidence and mortality, accounting for 2,4 million new cases and 1,8 million deaths in 2022. The most common symptoms of lung cancer include persistent cough, hemoptysis, weight loss, chest pain and dyspnea. One of the most common metastatic sites of lung cancer is the brain, with intracranial involvement in approximately 20% of patients at the time of diagnosis, and although rare the initial presentation of the disease can derive from this site. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, ALECTINIB TREATMENT OF ALK POSITIVE NON SMALL CELL LUNG CANCER PATIENTS WITH BRAIN METASTASES: OUR CLINICAL EXPERIENCE(Macedonian Academy of Sciences and Arts, 2020)Summary: Anaplastic lymphoma kinase (ALK) rearrangement is identified in approximately 3-7% of all metastatic non-small cell lung cancer (NSCLC) patients, and ALK tyrosine kinase inhibitors (TKIs) have revolutionized the management of this subset of lung cancer cases. Purpose: This study aims to show alectinib (TKI) effectiveness and safety with focus on alectinib intracranial efficacy for ALK+ NSCLC patients. Case presentation: Patient 1 was a 46-year-old woman diagnosed with non-small cell lung cancer with an echinoderm microtubule-associated protein-like 4-anaplastic lymphoma kinase fusion gene (ALK+). She presented with intracranial and liver metastases and poor performance status of ECOG 3. Alectinib was initiated as a second line therapy, after whole brain irradiation and discontinuation of first line chemotherapy after two cycles, due to the central nervous system progression and liver metastases. Good response was consequently achieved, characterized with improved overall performance and without significant adverse events. Patient 2 was a 53-year old man with left sided lung adenocarcinoma surgically treated in 2017. Post-operative pTNM stage was IIB with a positive resection margin- R1. He received adjuvant chemotherapy and radiotherapy. In 2019, after two and half years of being disease free, he presented with severe cerebral symptoms leading to poor performance status. CT scan of the brain showed multiple brain metastases. He was treated with first line alectinib after completion of whole brain radiotherapy. In 5 months period he got significantly better and able for work again. Conclusions: We recommend alectinib as a first and second line treatment approach for ALK+ NSCLC patients, in particular the ones with brain metastases at the time of diagnosis and poor PS.