{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T20:40:23Z","timestamp":1792269623821,"version":"4.4.0"},"reference-count":35,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T00:00:00Z","timestamp":1788393600000},"content-version":"vor","delay-in-days":2,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Respirology Case Reports"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Striatin\u2013anaplastic lymphoma kinase (STRN\u2013ALK) is a rare fusion variant in non\u2010small cell lung cancer (NSCLC), and the efficacy of first\u2010line lorlatinib for this subgroup is poorly defined. We report a 45\u2010year\u2010old treatment\u2010na\u00efve male with STRN\u2010ALK\u2010positive lung adenocarcinoma and symptomatic brain metastases. Following stereotactic radiosurgery for intracranial lesions, the patient initiated lorlatinib at 100\u2009mg once daily as the first systemic therapy. After starting treatment, neuropsychiatric side effects necessitated a gradual reduction in dosage to 75\u2009mg and then to 50\u2009mg. The patient achieved a durable partial response with sustained intracranial disease control for over 1\u2009year. Adjusting the dosage improved tolerability without compromising efficacy, allowing for ongoing treatment. This case demonstrates that first\u2010line lorlatinib can achieve durable systemic and intracranial disease control in STRN\u2013ALK\u2013positive NSCLC, including in patients presenting with brain metastases, while maintaining antitumor efficacy despite dose reduction.<\/jats:p>","DOI":"10.1002\/rcr2.70750","type":"journal-article","created":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T03:08:53Z","timestamp":1788491333000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["First\u2010Line Lorlatinib in Striatin\u2013Anaplastic Lymphoma Kinase\u2010Positive Lung Adenocarcinoma: A Case Report and Literature Review"],"prefix":"10.1002","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-6642-6250","authenticated-orcid":false,"given":"Masaru","family":"Maebeya","sequence":"first","affiliation":[{"name":"Internal Medicine III Wakayama Medical University Hospital  Wakayama Japan"},{"name":"Department of 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