Complete pathological response after ceritinib for anaplastic lymphoma kinase-rearranged epithelioid peritoneal mesothelioma

Our plain-English summary of Complete pathological response after ceritinib for anaplastic lymphoma kinase-rearranged epithelioid peritoneal mesothelioma, by S. Sakata, H. Rees, S. Parke, et al (ANZ Journal of Surgery, 2021).

The study

• Authors: S. Sakata, H. Rees, S. Parke, N.J. Carr, D. Kostadinov, N. Ahmadi, A. Tzivanakis, F. Mohamed, T.D. Cecil, B.J. Moran, S.P. Dayal
• Journal: ANZ Journal of Surgery
• Published: 2021;91(3):475-476
• Type of article: Letter
• Cited by: 1 article, as counted by NIH iCite
• Read it: PubMed · Publisher

In plain English

This letter to the editor reported a single case: a 14-year-old female with malignant epithelioid peritoneal mesothelioma, a cancer of the abdominal lining. The article does not mention asbestos or any cause of her disease. Scans showed widespread disease in the abdomen. Surgery combined with heated chemotherapy inside the abdomen (CRS and HIPEC) was not possible, and chemotherapy with cisplatin and pemetrexed gave no clinical response. Genetic profiling of the tumour found an STRN-ALK mutation. She was then given ceritinib, a drug aimed at ALK, at 450 mg a day, outside its approved use. After three months the peritoneal disease was dramatically reduced, and she underwent CRS and HIPEC five months after diagnosis. Examination of the removed tissue showed complete regression of the tumour. Eighteen months after her last ceritinib dose, scans showed no recurrence, and no adverse clinical effect of ceritinib was observed. The authors advocated screening for ALK fusions in patients with peritoneal mesothelioma who cannot have CRS and HIPEC. As one case, it shows what happened to one patient, not how often the treatment works.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: case report (letter to the editor)
• Who was studied: one 14-year-old female patient with malignant epithelioid peritoneal mesothelioma, treated at UK hospitals
• Exposure: No asbestos or other cause of the disease is mentioned. The treatment described was off-label oral ceritinib at 450 mg per day, given after an STRN-ALK mutation was found in the tumour.
• Main results:
  • Before ceritinib, chemotherapy with cisplatin and pemetrexed gave no clinical response.
  • Genomic profiling of the patient's tumour identified an STRN-ALK mutation.
  • After three months of ceritinib, the patient's peritoneal disease was dramatically reduced.
  • The patient then had CRS and HIPEC 5 months after diagnosis, and pathology showed complete regression of the tumour.
  • 18 months after the patient's last ceritinib dose, follow-up MRI scans showed no recurrence.
  • No adverse clinical effect of ceritinib was observed in this patient.
• The authors' conclusion: The authors advocated ALK fusion screening by comprehensive genomic profiling in patients with peritoneal mesothelioma who are not suitable for CRS and HIPEC.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Lung cancer, Mesothelioma.

Medical terms in this study, explained in our Lexicon: Epithelioid, Peritoneal Mesothelioma.

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• Anaplastic lymphoma kinase (ALK) translocation in paediatric malignant peritoneal mesothelioma: a case report of novel ALK-related tumour spectrum — K. Loharamtaweethong, N. Puripat, et al. (2016)
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• Acquired multiple mutations ALK I1171N, L1196M and G1202R mediate lorlatinib resistance in EML4-ALK-rearranged malignant pleural mesothelioma: a case report — J. Hu, B. Zhang, et al. (2020)
• Complete pathological response to neoadjuvant pemetrexed/cisplatin in combination with regional hyperthermia in a patient with sarcomatoid peritoneal mesothelioma — S. Kruger, M.K. Angele, et al. (2014)

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