Figure 1.

Serial CT images of the chest were collected in the first patient from the time of diagnosis through follow-up on lorlatinib. At the time of presentation with NSCLC, no parenchymal abnormalities were observed aside from the primary tumor (not shown) (A). However, bilateral, diffuse ground-glass opacities and septal thickening became apparent 29 days after the initiation of alectinib when the patient developed worsening respiratory symptoms and hypoxia (B). Approximately 5 weeks after initiating corticosteroids and discontinuing alectinib for grade 3 DI-ILD, the previously seen parenchymal abnormalities were significantly improved (C). After 10 weeks on lorlatinb therapy, despite progression of NSCLC (not shown), only faint ground-glass opacities were visible compared to prior (D). NSCLC, non-small cell lung cancer; DI-ILD, drug-induced interstitial lung disease.