Complete response of spinal metastases from non-small cell lung cancer with ALK inhibitors

Patients with ALK-rearranged non-small cell lung cancer (NSCLC) have a risk of developing metastases in the brain (35%–50%), leptomeninges (5%), and spinal cord (<1%).1 It is unclear whether this occurs as part of the natural history of the disease, regardless of the treatment received, or is strongly correlated to low CNS penetration of ALK inhibitors. Here we describe a prolonged clinical and radiologic response using sequential ALK inhibitors in leptomeningeal and spinal intramedullary lesions from ALK-rearranged NSCLC.