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Retinoids and interferon alpha have shown synergistic activity against metastatic renal cell carcinoma in previous preclinical and clinical studies. Based on these results, we conducted a phase II trial of 13-cis-retinoic acid (cRA) at 1 mg/kg/dose interferon alpha2a (IFN) at initial dose of 9 MU three times a week. Thirty-one patients were entered, all evaluable for toxicity and 30 evaluable for response. One patient achieved a partial response and 10 patients achieved stable disease. Toxicity was mild and primarily related to interferon. No toxic deaths were reported. Median survival time was 10 months. At the dose and schedule used, cRA and interferon-alpha2a showed low activity against metastatic renal cell carcinoma. Further studies with this combination are not recommended.

and other two new lesions in the right upper lobe. One was a 10mm nodule close to the scar of primary tumor, which had not found at chest CT from three months ago. The other was a 15mm nodule apart from the scar, which existed before the alectinib treatment and had got larger gradually. PET-CT revealed the high fluorodeoxyglucose (FDG) uptake of only two new lesions. We performed complete VATS right upper lobectomy and mediastinal lymph node dissection for treatment and diagnosis. Histopathlogical diagnoses: No residual viable cell was found in the primary lesion. The lesion close to the scar of the primary lesion was adenocarcinoma (ALK-rearranged), which was thought to be a recurrent lesion because of resemblance to brain metastasis in pathological tissue. The lesion apart from the main lesion was pT1bN0M0 StageIB squamous cell carcinoma, which was thought to be primary lung cancer. Alectinib was continued after the operation, and chest CT shows no sign of recurrence so far. Conclusion:We experienced a VATS right upper lobectomy for advanced non-small cell lung cancer after ALK-tyrosine kinase inhibitor administration.