• Medicine · Jul 2023

    Case Reports

    TCM monotherapy achieves significant efficacy in crizotinib-refractory advanced NSCLC with brain metastasis.

    • Jiqiu Qin, Ru Li, Hong Ma, Peng Ding, Qin Yang, Lilai Hu, Deliu Wu, and Shaoquan Xiong.
    • Department of Medical Oncology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China.
    • Medicine (Baltimore). 2023 Jul 21; 102 (29): e34138e34138.

    RationaleThe morbidity and mortality of lung cancer rank the first among all kinds of cancer. In China, anaplastic lymphoma kinase-positive pulmonary tumors account for nearly 5% of non-small cell lung cancer (NSCLC), and these patients are quite likely to develop brain metastases, as high as around 45%. Although anaplastic lymphoma kinase-tyrosine kinase inhibitors crizotinib and alectinib have proved effective for controlling tumor metastases to the brain, drug resistance and disease progression cannot be ignored in the course of treatment.Patient ConcernsMost of the literature reports that traditional Chinese medicine (TCM) has produced satisfactory results in the treatment of cancer patients as an adjuvant treatment for various malignancies in a 53-year-old male patient who developed advanced NSCLC with brain metastases. As first-line crizotinib and erlotinib treatments were ineffective and the intracranial lesions progressed extensively, the patient chose to receive TCM treatment alone in the hope of prolonging his life and improving his quality of life.DiagnosesA 53-year-old male patient who developed advanced NSCLC with brain metastasis. Because first-line crizotinib and alectinib have failed, and the intracranial lesions progressed in a large area.InterventionsThe patient requested that the final therapeutic strategy be Chinese medicine as monotherapy for long-term treatment. The patient took 30 mL of the decoction 1 hour after a meal, 3 times a day. The patient was not treated with dehydrating agents or diuretics during the TCM treatment.OutcomesThe improvement was obvious after 3 months of treatment, and significant reduction of cranial lesions. During the follow-up period, the patient developed neither severe liver damage nor kidney damage.LessonsThis case is the first 1 in the world where TCM was introduced as monotherapy for severe conditions with extensive brain metastases and achieved remarkable efficacy.Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.

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