Effective Treatment of Choroidal Metastasis With ALK Inhibitor Chemotherapy That Crosses the Blood–Brain Barrier

We report a case of metastatic non-small cell lung cancer (NSCLC) with choroidal metastasis, which responded to oral ensartinib. Retrospective case report on a 44-year-old male with a past medical history significant for metastatic NSCLC with a positive anaplastic lymphoma kinase (ALK) translocation that was treated for 4 years with oral crizotinib systemically, and bevacizumab intravitreal injections for management of subretinal fluid associated with a left macular choroidal metastasis. The vision was maintained at 20/25 to 20/40, but there was steady growth in the breadth and thickness of the choroidal lesion. Two months after starting daily oral ensartinib, his vision improved from 20/40 to 20/20. His lesion decreased significantly in size, with resolution of his subretinal fluid, and has not required any additional bevacizumab intravitreal injections in the 8 months since starting ensartinib. Ensartinib may be beneficial in the treatment of choroidal metastases in patients with NSCLC with ALK mutations