DOI: 10.1093/icvts/ivag280 ISSN: 2753-670X
Minimally invasive lobectomy following pathologic complete response to neoadjuvant Lorlatinib in ALK-positive squamous cell carcinoma
Alexandra Molkova, Ruifeng Li, Shuben LiAbstract
ALK rearrangements are uncommon in lung squamous cell carcinoma, and neoadjuvant ALK inhibition remains investigational. We report a 52-year-old never-smoking female with stage IIIB ALK-positive squamous cell carcinoma treated with neoadjuvant lorlatinib for 12 weeks. Serial imaging demonstrated a 61% reduction in tumor size with nodal regression. The patient subsequently underwent a uniportal video-assisted thoracoscopic (uVATS) lobectomy, and final pathology revealed a complete pathological response (pCR) of the primary tumor. This case highlights the feasibility and safety of minimally invasive anatomical lung resection following neoadjuvant lorlatinib despite treatment-related hilar fibrosis and vascular–bronchial adhesions.