CASE REPORT article
Front. Oncol.
Sec. Thoracic Oncology
This article is part of the Research TopicEditor's Challenge: Dr. Sara Pilotto - Modulating Tumor-Host Interplay through Lifestyle in Lung CancerView all 4 articles
Managing lorlatinib-induced weight gain through a structured exercise intervention in an ALK+ NSCLC patient: a case report
Provisionally accepted
Christian Ciurnelli1Ilaria Mariangela Scaglione1
Serena Eccher1
Anita Borsati1
LINDA TONIOLO1Gloria Adamoli1Daniela Tregnago1Lucia Longo1
Marco Sposito1Jessica Insolda1
Michele Milella1
Federico Schena1
Morten Quist2
Lorenzo Belluomini1Sara Pilotto1
Alice Avancini1*- 1University of Verona, Verona, Italy
- 2University Hospital of Copenhagen, Copenhagen, Denmark
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Background: In non-small cell lung cancer (NSCLC), ALK tyrosine kinase inhibitors (TKIs) have been associated with significant weight gain, predominantly in fat tissues. To date, only one case report has evaluated the impact of pharmacologic intervention on managing this drug-related side effect, with concerns about potential interactions with oncological treatments. No information is available regarding non-pharmacological intervention. Case description: A 43-year-old man affected by metastatic ALK-rearranged NSCLC developed Grade 1 weight gain 1.5 months after starting Lorlatinib. The patient participated in a structured exercise program to manage this side effect. The program lasted 6 months and consisted of aerobic activities, including continuous and interval training, as well as resistance exercises using body weight/isotonic machines, performed at moderate to somewhat vigorous intensity, twice a week. Assessments were performed at three and six months, and included physical fitness and patient-reported outcomes parameters. Although the weight remained stable, body composition analysis, via bioimpedance and CT scan, revealed a decrease in fat tissue and an increase in muscle mass. Moreover, the patient reported improvements in physical fitness, especially in cardiorespiratory fitness, muscle strength, endurance, and flexibility. Among the patient-reported outcomes, different domains of quality of life improved. Conclusion: This case may represent the backbone for further interventional studies aimed at determining the real efficacy of exercise intervention in preventing or controlling weight gain in this population.
Keywords: lorlatinib, Weight Gain, lung cancer, physical exercise, weight management, Body Composition
Received: 24 Jul 2025; Accepted: 07 Nov 2025.
Copyright: © 2025 Ciurnelli, Mariangela Scaglione, Eccher, Borsati, TONIOLO, Adamoli, Tregnago, Longo, Sposito, Insolda, Milella, Schena, Quist, Belluomini, Pilotto and Avancini. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Alice Avancini, alice.avancini@univr.it
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