{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T00:29:36Z","timestamp":1747182576716,"version":"3.40.5"},"reference-count":13,"publisher":"Wiley","issue":"15","license":[{"start":{"date-parts":[[2021,6,23]],"date-time":"2021-06-23T00:00:00Z","timestamp":1624406400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Thoracic Cancer"],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Echinoderm microtubule\u2010associated protein\u2010like 4\u2010anaplastic lymphoma kinase (EML4\u2010ALK) rearrangements are found in ~\u20095% of patients with non\u2010small cell lung cancer (NSCLC). Several tyrosine kinase inhibitors (TKIs) have been developed for treatment of so\u2010called ALK\u2010positive NSCLC. In cases of tumor progression during treatment with second\u2010generation ALK\u2010TKIs, such as alectinib, brigatinib, or ceritinib, National Comprehensive Cancer Network guidelines propose a switch to lorlatinib, a third\u2010generation ALK\u2010TKI, or to cytotoxic chemotherapy. However, they do not mention switching to other second\u2010generation ALK\u2010TKIs. Here, we present a rare case of a 53\u2010year\u2010old Japanese woman, who had never smoked, with ALK\u2010positive lung adenocarcinoma who survived alectinib\u2010resistant postoperative recurrence for 4\u2009years by switching to ceritinib. She underwent curative resection for lung adenocarcinoma, but the cancer recurred at the bronchial stump and mediastinal lymph nodes. After platinum\u2010doublet chemotherapy, the patient still had a single growing liver metastasis, but the tumor was found to harbor EML4\u2010ALK rearrangement. Therefore, the patient started to take ALK\u2010TKIs. Alectinib was the second ALK\u2010TKI used to treat this patient. Alectinib shrank the liver metastasis, which was surgically resected. The tumor relapsed again during continued treatment with alectinib, which was switched to ceritinib. Ceritinib was effective for the relapsed tumor and treatment continued well for 4\u2009years. This case report suggests that, in case of tumor progression during treatment with a second\u2010generation ALK\u2010TKI, switching to another second\u2010generation ALK\u2010TKI may be one of the treatment options. Further analyses are warranted to find robust markers to determine which ALK\u2010TKI is best for each patient.<\/jats:p>","DOI":"10.1111\/1759-7714.14058","type":"journal-article","created":{"date-parts":[[2021,6,23]],"date-time":"2021-06-23T07:56:06Z","timestamp":1624434966000},"page":"2225-2228","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["A patient with <scp>ALK<\/scp>\u2010positive lung adenocarcinoma who survived alectinib\u2010refractory postoperative recurrence for 4\u2009years by switching to ceritinib"],"prefix":"10.1111","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5106-0877","authenticated-orcid":false,"given":"Yuki","family":"Matsumura","sequence":"first","affiliation":[{"name":"Department of Chest Surgery Fukushima Medical University  Fukushima 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