Ma Lin, Xiao Junjuan, Guan Yaping, Wu Dongfang, Gu Tiantian, Wang Jun
Department of Oncology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, China.
Shandong Lung Cancer Institute, Jinan, China.
Front Oncol. 2022 Mar 4;12:860060. doi: 10.3389/fonc.2022.860060. eCollection 2022.
Rearrangements of Anaplastic lymphoma kinase () have been discovered as a novel driver mutation in patients with non-small-cell lung cancer (NSCLC). Patients' responses to ALK tyrosine kinase inhibitors (TKIs) may vary depending on the variations of rearrangements they have. It is imperative for clinicians to identify druggable fusions in routine practice.
In this study, we discovered a rare rearrangement type () in a Chinese lung adenocarcinoma patient who responded well to ALK inhibitor SAF-189s. The positive expression of ALK in lung biopsy tissue was verified by IHC analysis. A new fusion was discovered using NGS. The patient was treated with SAF-189s (160 mg per day) as a first-line therapy and went into continuous remission, with a 12 months progression-free survival at the last follow-up.
This is the first case of fusion with an excellent response to an ALK inhibitor, which will provide better understanding of ALK-TKI applications for NSCLC patients with fusion in the future.
间变性淋巴瘤激酶（ALK）重排在非小细胞肺癌（NSCLC）患者中被发现是一种新的驱动突变。患者对ALK酪氨酸激酶抑制剂（TKIs）的反应可能因其所具有的ALK重排变异而有所不同。临床医生在日常实践中识别可靶向治疗的ALK融合至关重要。
在本研究中，我们在中国一名肺腺癌患者中发现了一种罕见的ALK重排类型（），该患者对ALK抑制剂SAF-189s反应良好。通过免疫组化分析验证了肺活检组织中ALK的阳性表达。使用二代测序（NGS）发现了一种新的ALK融合。该患者接受SAF-189s（每天160毫克）作为一线治疗，进入持续缓解期，最后一次随访时无进展生存期为12个月。
这是首例对ALK抑制剂有良好反应的ALK融合病例，这将为未来更好地理解ALK-TKI在具有ALK融合的NSCLC患者中的应用提供帮助。
