Pathological complete response of a patient with ALK-translocated adenocarcinoma of the lung upon treatment with crizotinib followed by alectinib

Here we report the case of an ALK-positive NSCLC patient with pathological complete response within 6 months of treatment with crizotinib. This remission was further documented by PET-CT scans until 25 months after initial start of treatment where new brain lesions were detected on MRI. At this time, the patient received local treatment and then alectinib with partial response of the brain metastases and ongoing status of no systematic disease in the PET scans. This case emphasizes the relevance of brain MRI in the follow-up of patients with ALK-translocated adenocarcinoma of the lung, the long-term response to crizotinib and the possibility of CNS disease control with alectinib.