Advancing targeted therapy in advanced ALK+ non-small cell lung cancer

Introduction: We present the case of a 53-year-old male diagnosed with stage IVB ALK+ lung adenocarcinoma, with no significant comorbidities. Case report: Over a 10-year period, the patient received eight lines of therapy, including multiple generations of ALK inhibitors (crizotinib, brigatinib, alectinib, lorlatinib, and neladalkib), in combination with stereotactic brain radiotherapy, metastasectomy, and systemic chemotherapy. Conclusion: The case highlights the durable disease control achieved, particularly in the central nervous system, leading to an overall survival of 11 years. This case exemplifies the therapeutic sequencing and multidisciplinary challenges in the management of advanced ALK+ non-small cell lung cancer.