DOI: https://doi.org/10.36347/sjmcr.2025.v13i01.031

Pages: 139-143

Bronchial cancers are the leading cause of brain metastases and, in the absence of treatment, the median survival time for patients with bronchial cancer complicated by symptomatic brain metastases is approximately one month. Genetic sequencing has radically changed the management of non-small cell lung cancer over the last few decades. Anaplastic lymphoma kinase (ALK) rearrangements are responsible for 3-7% of non-small cell lung cancers. Patients with ALK-positive non-small cell lung cancer have a particular phenotype compared with other non-small cell lung cancers: they are younger, non-smokers and more frequently present with brain metastases. Anaplastic lymphoma kinase (ALK) tyrosine kinase inhibitors (TKI) are the standard recommended first-line treatment for patients with ALK-positive in non-small cell lung cancer. Lorlatinib is a third-generation brain-penetrant ALK TKI that has greater coverage of ALK resistance mutations than second-generation ALK inhibitors. Conclusion: Brain metastases are a poor prognostic factor and are common in non-small cell lung cancer. Lorlatinib is a potent third-generation ALK tyrosine kinase inhibitor that has improved penetration of the central nervous system across the blood-brain barrier, resulting in higher intracranial response rates and preventing brain metastases.