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Case Report: A Novel Non-Reciprocal ALK Fusion: ALK-GCA and EML4-ALK Were Identified in Lung Adenocarcinoma, Which May Respond to Alectinib Adjuvant-Targeted Therapy
被引:4
|作者:
Zhai, Xiaoqian
[1
]
Wu, Qiang
[1
]
Pu, Dan
[1
]
Yin, Liyuan
[1
]
Wang, Weiya
[2
]
Zhu, Daxing
[1
]
Xu, Feng
[1
]
机构:
[1] Sichuan Univ, West China Hosp, Lung Canc Ctr, Chengdu, Peoples R China
[2] Sichuan Univ, West China Hosp, Pathol Dept, Chengdu, Peoples R China
来源:
基金:
中国国家自然科学基金;
关键词:
ALK fusion;
ALK-GCA and EML4-ALK;
stage IIIB-N2 NSCLC;
alectinib;
adjuvant targeted therapy;
POSTOPERATIVE RADIOTHERAPY;
CANCER;
CRIZOTINIB;
CHEMOTHERAPY;
SURVIVAL;
D O I:
10.3389/fonc.2021.782682
中图分类号:
R73 [肿瘤学];
学科分类号:
100214 ;
摘要:
Anaplastic lymphoma kinase (ALK)-positive non-small-cell lung cancers (NSCLCs) have favorable and impressive response to ALK tyrosine kinase inhibitors (TKIs). However, ALK rearrangement had approximately 90 distinct fusion partners. Patients with different ALK fusions might have distinct responses to different-generation ALK-TKIs. In this case report, we identified a novel non-reciprocal ALK fusion: ALK-grancalcin (GCA) (A19: intragenic) and EML4-ALK (E20: A20) by next-generation sequencing (NGS) in a male lung adenocarcinoma patient who was staged as IIIB-N2 after surgery. After a multidisciplinary discussion, the patient received alectinib adjuvant targeted therapy and postoperative radiotherapy (PORT). He is currently in good condition, and disease-free survival (DFS) has been 20 months so far, which has been longer than the median survival time of IIIB NSCLC patients. Our study extended the spectrum of ALK fusion partners in ALK + NSCLC, and we reported a new ALK fusion: ALK-GCA and EML4-ALK and its sensitivity to alectinib firstly in lung cancer. It is vital for clinicians to detect fusion mutations of patients and report timely the newfound fusions and their response to guide treatment.
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