Department of Thoracic Surgery, China-Japan Union Hospital of Jilin University, Changchun, China.
Department of Pathology, China-Japan Union Hospital of Jilin University, Changchun, China.
Thorac Cancer. 2022 Aug;13(15):2275-2278. doi: 10.1111/1759-7714.14558. Epub 2022 Jul 12.
Here, we first report a case of neoadjuvant ceritinib for locally advanced lung adenosquamous carcinoma. In this study, a locally advanced adenosquamous carcinoma (ASC) patient with EML4-ALK fusion who achieved a partial response with neoadjuvant ceritinib treatment after a cycle of neoadjuvant chemotherapy did not show significant efficacy. A complete surgical resection was performed with mild adhesions and a small amount of bleeding intraoperatively. The EML4-ALK fusion was detected by targeted next-generation sequencing (NGS) in both pretreatment biopsy and the postoperative tissue specimens with a dramatic decrease in the allele frequency (26.2% [pre]-2.3% [post]). Pathological examination of the postoperative specimens indicated a diagnosis of ASC but the proportions of adenocarcinoma and squamous cell carcinoma cells in the primary lung tumor and metastatic lymph node site were different, suggesting the various responses to ceritinib. Thus, with the case presented here, we provide the clinical evidence for ALK-positive locally advanced ASC patients benefiting from neoadjuvant ceritinib treatment with a tolerable safety profile, whereas further cohort studies of the efficacy and safety of neoadjuvant ceritinib in such patients are needed.
在这里，我们首次报告了一例局部晚期肺腺鳞癌患者接受新辅助色瑞替尼治疗的情况。在这项研究中，一例局部晚期腺鳞癌（ASC）患者存在 EML4-ALK 融合，在接受新辅助化疗一个周期后，新辅助色瑞替尼治疗取得了部分缓解，但并未显示出显著疗效。手术时，仅见轻度粘连，术中出血量少。通过靶向二代测序（NGS）在术前活检和术后组织标本中均检测到 EML4-ALK 融合，等位基因频率明显下降（26.2%[术前]-2.3%[术后]）。术后标本的病理检查提示 ASC 的诊断，但原发肺肿瘤和转移淋巴结部位的腺癌和鳞状细胞癌细胞的比例不同，提示对色瑞替尼的不同反应。因此，通过本例患者，我们提供了临床证据，表明ALK 阳性局部晚期 ASC 患者从新辅助色瑞替尼治疗中获益，且具有可耐受的安全性特征，但需要进一步开展此类患者新辅助色瑞替尼治疗的疗效和安全性的队列研究。
