{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T12:37:55Z","timestamp":1763728675180,"version":"3.41.2"},"reference-count":11,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,1,26]],"date-time":"2024-01-26T00:00:00Z","timestamp":1706227200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Lorlatinib is a new generation ALK kinase inhibitor. We describe a 52-year-old patient with ALK-positive advanced lung adenocarcinoma who achieved remission after multi-line therapy combined with paraneoplastic leukemoid reaction treated with Lorlatinib.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case report<\/jats:title><jats:p>A 52-year-old male patient was diagnosed with stage IV right lung adenocarcinoma, ALK: (+), previously received oral Crizotinib and Alectinib. Blood routine showed white blood cells abnormally elevated after disease progression, and maximum white blood cell count was 179.14\u00d710^9\/L. The patient was enrolled in study entitled \u201ca phase II, multicenter, open-label, dual-cohort study to evaluate the efficacy and safety of LORLATINIB monotherapy in ALK inhibitor-treated locally advanced or metastatic ALK-positive non-small cell lung cancer patients in China\u201d. With oral Lorlatinib, the white blood cell count decreased from 179.14\u00d710^9\/L to normal after two weeks of administration. PFS was 4.5 months. When follow up imaging showed lesions progression, the white blood cell count increased again, diagnosing a paraneoplastic leukemic reaction. OS was 5.2 months.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In this case, fourth-line Lorlatinib treatment is effiective in ALK-positive advanced patient with paraneoplastic leukemoid reaction. ClinicalTrials.gov Identifier: NCT03909971<\/jats:p><\/jats:sec>","DOI":"10.3389\/fonc.2024.1341233","type":"journal-article","created":{"date-parts":[[2024,1,26]],"date-time":"2024-01-26T04:29:18Z","timestamp":1706243358000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Effective treatment of advanced lung adenocarcinoma with paraneoplastic leukemoid reaction with Lorlatinib: a case report"],"prefix":"10.3389","volume":"14","author":[{"given":"Ruiqi","family":"Niu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yiruo","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jingdan","family":"Pang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qing","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu","family":"Lei","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yingying","family":"Du","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2024,1,26]]},"reference":[{"key":"B1","doi-asserted-by":"crossref","DOI":"10.1182\/blood.V49.5.845.845","article-title":"Demonstration of granulopoietic factor(s) in the plasma of nude mice transplanted with a human lung cancer and in the tumor tissue","volume":"49","author":"Asano","year":"1977","journal-title":"Blood"},{"key":"B2","doi-asserted-by":"publisher","first-page":"326","DOI":"10.1097\/COC.0b013e3182a530dd","article-title":"Paraneoplastic leukemoid reaction in solid tumors","volume":"38","author":"Chakraborty","year":"2015","journal-title":"Am J Clin Oncol"},{"key":"B3","doi-asserted-by":"publisher","first-page":"838","DOI":"10.4065\/mcp.2010.0099","article-title":"Paraneoplastic syndromes: An approach to diagnosis and treatment","volume":"85","author":"Pelosof","year":"2010","journal-title":"Mayo Clinic Proc"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(20011101)92:9<2399::aid-cncr1588>3.0.co;2-w","article-title":"Tumor-related leukocytosis is linked with poor prognosis in patients with lung carcinoma","volume":"92","author":"Kasuga","year":"2001","journal-title":"Cancer"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.24480","article-title":"Etiology and outcome of extreme leukocytosis in 758 nonhematologic cancer patients: A retrospective, single-institution study","volume":"115","author":"Granger","year":"2009","journal-title":"Cancer"},{"key":"B6","doi-asserted-by":"publisher","first-page":"197","DOI":"10.1016\/s0025-6196(12)60050-0","article-title":"Paraneoplastic syndromes associated with lung cancer","volume":"5","author":"Kanaji","year":"2014","journal-title":"WJCO"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1177\/1751143720975316","article-title":"Moderate to severe leukocytosis with vasopressor use is associated with increased mortality in trauma patients","volume":"23","author":"Hasjim","year":"2022","journal-title":"J Intensive Care Soc"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.18.02236","article-title":"ALK resistance mutations and efficacy of lorlatinib in advanced anaplastic lymphoma kinase-positive non\u2013small-cell lung cancer","volume":"37","author":"Shaw","year":"2019","journal-title":"JCO"},{"key":"B9","doi-asserted-by":"publisher","first-page":"153295","DOI":"10.1016\/j.prp.2020.153295","article-title":"Paraneoplastic leukemoid reaction: case report and review of the literature","volume":"217","author":"Abukhiran","year":"2021","journal-title":"Pathol - 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