Department of Medical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, People's Republic of China.
Cancer Biol Ther. 2020;21(1):12-16. doi: 10.1080/15384047.2019.1665957. Epub 2019 Sep 27.
Targeted therapy has revolutionized the treatment pattern of advanced drive gene mutation positive non-small cell lung cancer (NSCLC). Advanced testing techniques enable physicians to detect these gene alterations in the clinic, thereby offering targeted therapies as treatment options to their patients. In this article, we reported a 52-year-old Chinese female with a pulmonary nodule in her left lower lung. After thoracoscopic lobectomy, a histopathological diagnosis of moderately differentiated atypical carcinoid (AC) was made. Anaplastic lymphoma kinase (ALK) rearrangement was detected, which is a rare phenomenon in AC. After the failure of chemotherapy and radiotherapy, the patient started taking crizotinib, subsequently with ceritinib, and then alectinib. This sequential therapy approach has significant clinical benefits for the patient. This article reviewed the clinical significance and drug resistance mechanism of ALK rearrangement in lung cancer. We also discussed recent and ongoing researches and applications of ALK-tyrosine kinase inhibitors (ALK-TKIs).
靶向治疗已经彻底改变了晚期驱动基因阳性非小细胞肺癌(NSCLC)的治疗模式。先进的检测技术使医生能够在临床中检测到这些基因改变,从而为患者提供靶向治疗作为治疗选择。在本文中,我们报告了一名 52 岁的中国女性,她的左下肺有一个肺结节。在胸腔镜肺叶切除术后,组织病理学诊断为中分化非典型类癌(AC)。检测到间变性淋巴瘤激酶(ALK)重排,这在 AC 中较为罕见。在化疗和放疗失败后,患者开始服用克唑替尼,随后是塞瑞替尼,然后是阿来替尼。这种序贯治疗方法对患者具有显著的临床获益。本文综述了肺癌中 ALK 重排的临床意义和耐药机制。我们还讨论了 ALK-酪氨酸激酶抑制剂(ALK-TKIs)的最新研究进展和应用。