Department of Thoracic Disease Center, Zhejiang Rongjun Hospital, Jiaxing, China.
Department of Pathology, Jiaxing University College of Medicine, Jiaxing, China.
Thorac Cancer. 2018 Jan;9(1):159-163. doi: 10.1111/1759-7714.12518. Epub 2017 Oct 3.
Lung adenocarcinomas with gene rearrangement in the receptor tyrosine kinase ROS1 have emerged as a rare molecular subtype. Although these lung adenocarcinomas respond to ROS1tyrosine kinase inhibitors, many patients ultimately acquire resistance. ROS1gene rearrangement is generally mutually exclusive with other driver genomic alterations, such as those in EGFR, KRAS, or ALK, thus multiple genomic alterations are extremely rare. Herein, we report a case of a 42-year-old man diagnosed with lung adenocarcinoma positive for a SDC4-ROS1 fusion, who was treated with crizotinib followed by three cycles of chemotherapy. A biopsy acquired after disease progression revealed the original SDC4-ROS1 fusion along with a KRAS point mutation (p.G12D).We reviewed the related literature to determine the frequency of gene mutations in non-small cell lung cancer patients. A better understanding of the molecular biology of non-small cell lung cancer with multiple driver genomic aberrations will assist in determining optimal treatment.
ROS1 受体酪氨酸激酶基因重排的肺腺癌已成为一种罕见的分子亚型。虽然这些肺腺癌对 ROS1 酪氨酸激酶抑制剂有反应，但许多患者最终会产生耐药性。ROS1 基因重排通常与其他驱动基因改变（如 EGFR、KRAS 或 ALK 改变）相互排斥，因此多种基因改变极为罕见。在此，我们报告一例 42 岁男性肺腺癌患者，该患者 SDC4-ROS1 融合阳性，接受克唑替尼治疗后进展时进行了三次化疗。疾病进展时获得的活检显示，原始 SDC4-ROS1 融合伴有 KRAS 点突变（p.G12D）。我们回顾了相关文献，以确定非小细胞肺癌患者基因突变的频率。更好地了解具有多个驱动基因异常的非小细胞肺癌的分子生物学将有助于确定最佳治疗方案。
