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Q. What are the next treatment options for my brother's condition?

Answered by
Dr. Bharat Patodiya
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Jul 29, 2016 and last reviewed on: Jun 11, 2020

Hi doctor,

My brother was diagnosed to have ALK positive before two years. He had brain and bone metastasis. He got a brain surgery, WBR and spine radiation. He was on Crizotinib for 10 months and after brain and bone metastasis progression he was on Ceritinib for 5 months. In the latest scan, the disease progression was seen again in bone and also there was a new brain metastasis. Unfortunately, in my country, there is no next generation inhibitor of Ceritinib. What are the options now? Is there any chance to use Crizotinib again? He has some bone fractures also. We are feeling helpless. He is just 35 only. Already, he had WBR twice. What are the next treatment options? When he was on Crizotinib, he felt very active. But, while on Ceritinib, he mostly used to stay on the bed. Kindly suggest some option.

Dr. Bharat Patodiya

General Medicine Internal Medicine Medical Oncology


Welcome to

I understand your plight.

  • There are a few options more at this time if general condition is good.
  • From the details it appears that chemotherapy is not exhausted yet and it can be utilized now.
  • If only targeted agents are to be discussed, then Alectinib can be offered.
  • Next generation sequencing is also an option. However, I would like to mention that the treatment depends on the general condition of the patient.

For further information consult a medical oncologist online -->

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Thank you so much for the reply doctor,

Currently, he is very weak. Alectinib is not available in my country. How to get it? Or shall we continue the same drug and do radiation to the bone? Do you know any clinical trials of targeted therapy after Ceritinib? Kindly reply.

Dr. Bharat Patodiya

General Medicine Internal Medicine Medical Oncology


Welcome back to

  • There are a few people who can help us to import. However, if his general condition is too weak, then probably supportive care will be the only option.
  • You need to discuss his tolerability to TKI (tyrosine kinase inhibitor) or chemotherapy with the oncologist who has seen him.

For further information consult a medical oncologist online -->

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