Thumallapally Nishitha, Yu Hana, Farhan Mohammad, Ibrahim Uroosa, Odiami Maricel
1 Department of Medicine, Staten Island University Hospital, Staten Island, NY, USA.
2 Department of Hematology/Oncology, Staten Island University Hospital, Staten Island, NY, USA.
J Pharm Pract. 2018 Apr;31(2):244-248. doi: 10.1177/0897190017704751. Epub 2017 Apr 25.
Empirical evidence has long suggested that oncogenic driver mutations in non-small-cell lung cancer are mutually independent. However, recent studies reported in pertinent literature reveal that concomitant epidermal growth factor receptor (EGFR) mutations and anaplastic lymphoma kinase (ALK) rearrangement can occur in a subset of patients with NSCLC. In order to shed further light on this issue, we report a case of adenocarcinoma of lung harboring both EGFR mutation in exon 21 (L861Q) and ALK rearrangement. This allows us to speculate on likely molecular mechanisms underlying this uncommon phenomenon, while also offering some practical guidelines on the therapeutic options that could benefit patients diagnosed with this dual-positive tumor.
长期以来，经验证据表明非小细胞肺癌中的致癌驱动基因突变是相互独立的。然而，相关文献中最近报道的研究显示，在一部分非小细胞肺癌患者中可同时出现表皮生长因子受体（EGFR）突变和间变性淋巴瘤激酶（ALK）重排。为了进一步阐明这一问题，我们报告了1例同时存在第21外显子EGFR突变（L861Q）和ALK重排的肺腺癌病例。这使我们能够推测这一罕见现象背后可能的分子机制，同时也为可能使诊断为这种双阳性肿瘤的患者受益的治疗选择提供一些实用指南。
