Teenager stands strong against cancerous lungs.

Alectinib Offers Hope: A Teen's Victory Over Lung Cancer

Jordan Keane in Health & Wellness December 2025 • 4 min read.

"How a targeted therapy provided a safe and effective path to remission for an adolescent battling advanced ALK-rearranged adenocarcinoma."

Lung cancer, particularly adenocarcinoma, is rare in adolescents, making treatment strategies challenging. When the cancer also involves a specific genetic anomaly, like the ALK rearrangement, targeted therapies become crucial. Alectinib, an ALK inhibitor, has demonstrated success in adults, but its use in younger patients is less documented.

A recent case study highlights the potential of alectinib in treating a 14-year-old girl diagnosed with stage IVB ALK-rearranged adenocarcinoma of the lung. The patient presented with typical symptoms like cough and fever, leading to a diagnosis of advanced lung cancer with metastases.

What makes this case significant is the successful application of alectinib, typically used in adults, to achieve a complete metabolic remission in this young patient. This offers hope and provides valuable data for treating similar cases in the future.

Alectinib: A Targeted Solution for ALK-Rearranged Lung Cancer

Teenager stands strong against cancerous lungs.

Anaplastic lymphoma kinase (ALK) inhibitors such as crizotinib and alectinib have revolutionized the treatment of ALK-rearranged non-small cell lung cancers (NSCLC). These inhibitors target the ALK protein, which, when rearranged, drives the growth of cancer cells. Alectinib, a second-generation ALK inhibitor, has shown superiority over conventional chemotherapy and first-generation inhibitors like crizotinib in adult trials.

The 14-year-old patient was started on alectinib at an adult dose of 600 mg twice daily, carefully monitored by a multidisciplinary team. The rationale behind using the adult dose was based on the patient's weight (60 kg) and body surface area (1.60 m²), as well as the lack of specific pediatric dosing guidelines.

Significant Remission: After four weeks, CT and FDG PET/CT scans revealed significant improvements. Lymphadenopathy decreased, lung masses reduced in size, and lung metastases disappeared.
Complete Metabolic Response: FDG PET/CT scans showed no abnormal metabolic activity at the primary and metastatic disease sites.
Sustained Results: Follow-up imaging at four, six, and nine months confirmed an ongoing complete metabolic response and further reduction in the primary disease size.

Throughout the treatment, the patient experienced manageable adverse events, including grade 1 photosensitivity, anemia, hyperbilirubinemia, and elevated hepatic transaminases, and grade 2 ovulation pain. Importantly, she did not experience the more severe side effects often associated with alectinib, such as symptomatic bradycardia or interstitial lung disease.

The Future of Adolescent Lung Cancer Treatment

This case offers a beacon of hope for adolescents facing advanced lung cancer with ALK rearrangements. Alectinib's success in achieving and sustaining remission, coupled with manageable side effects and improved quality of life, positions it as a promising treatment option. The collaborative approach between pediatric and adult oncologists, as demonstrated in this case, is essential for delivering optimal, age-appropriate care. Further research and clinical trials are needed to establish pediatric-specific dosing guidelines and to explore the long-term efficacy and safety of alectinib in this unique patient population.

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Everything You Need To Know

What is alectinib, and how does it work to combat lung cancer?

Alectinib is a targeted therapy drug known as an ALK inhibitor. It works by specifically targeting the ALK protein, which, when it's rearranged due to genetic anomalies, can cause cancer cells to grow uncontrollably, particularly in cases of ALK-rearranged non-small cell lung cancers (NSCLC). By inhibiting the activity of the ALK protein, alectinib helps to slow down or stop the growth of cancer cells. Alectinib is considered a second-generation ALK inhibitor and has demonstrated better results compared to first-generation inhibitors like crizotinib.

What exactly is ALK-rearranged adenocarcinoma, and why is it important to identify it?

ALK-rearranged adenocarcinoma is a specific type of lung cancer, particularly adenocarcinoma, where the ALK gene has undergone a rearrangement. This rearrangement leads to the production of an abnormal ALK protein that drives the growth of cancer cells. It's significant because identifying this specific genetic anomaly allows for the use of targeted therapies like alectinib, which can precisely target the ALK protein and inhibit its activity. The identification of ALK rearrangements has revolutionized treatment approaches for this subset of lung cancers, offering more effective and personalized treatment options.

What does it mean when a patient achieves complete metabolic remission?

Complete metabolic remission, as determined by FDG PET/CT scans, indicates that there is no longer any detectable abnormal metabolic activity in the primary and metastatic disease sites. This means that the cancer cells are no longer actively growing or spreading in the body. Achieving complete metabolic remission is a significant treatment goal, suggesting that the therapy is highly effective in eliminating or controlling the cancer.

Why is targeted therapy, like the use of alectinib, so important in treating certain types of lung cancer?

Targeted therapy like alectinib is important because it offers a more precise and effective approach to cancer treatment, especially in cases with specific genetic anomalies like ALK rearrangements. Unlike traditional chemotherapy, which can affect both cancer cells and healthy cells, targeted therapies specifically target the molecules and pathways that drive cancer growth. This approach can lead to better outcomes, fewer side effects, and improved quality of life for patients. The use of targeted therapy also highlights the importance of genetic testing in cancer diagnosis to identify actionable mutations and tailor treatment accordingly.

Why is it important to manage adverse events when a patient is being treated with alectinib?

Managing adverse events is crucial when using treatments like alectinib. Adverse events, such as photosensitivity, anemia, hyperbilirubinemia, and elevated hepatic transaminases, need careful monitoring and management to ensure patient safety and quality of life. These side effects are typically managed with supportive care and dose adjustments, and they are an important consideration in the overall treatment plan. The ability to manage these adverse events effectively allows patients to continue benefiting from the therapeutic effects of alectinib while minimizing discomfort and potential complications.