Department of Thoracic Surgery, the Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
Anticancer Drugs. 2023 Jun 1;34(5):699-706. doi: 10.1097/CAD.0000000000001432. Epub 2022 Nov 18.
Although neoadjuvant target therapy has been used to treat patients with non-small-cell lung cancer (NSCLC), most of these patients have mutations in the epidermal growth factor receptor (EGFR) gene. Few patients to date have received neoadjuvant target therapy for NSCLC containing variants in genes encoding anaplastic lymphoma kinase-tyrosine kinase inhibitors (ALK-TKIs). Herein, we present a 51-year-old man with a lung mass in the left lower lobe with enlarged mediastinal lymph nodes. He was diagnosed with NSCLC after needle lung biopsy, with next-generation sequencing showing an echinoderm microtubule-associated protein-like 4 gene-anaplastic lymphoma kinase (EML4-ALK) fusion variant. The patient received neoadjuvant ensartinib, a second-generation ALK-TKI, for 5 months, followed by successful lobectomy through uniportal video-assisted thoracic surgery and adjuvant ensartinib. To our knowledge, few patients with ALK-positive NSCLC had received neoadjuvant treatment with ensartinib. Findings in this patient may widen indications for neoadjuvant target therapy in the treatment of resectable stage II-IIIA ALK-positive NSCLC.
尽管新辅助靶向治疗已被用于治疗非小细胞肺癌（NSCLC）患者，但这些患者中的大多数存在表皮生长因子受体（EGFR）基因突变。迄今为止，很少有 NSCLC 患者接受过针对编码间变性淋巴瘤激酶酪氨酸激酶抑制剂（ALK-TKIs）的基因变异的新辅助靶向治疗。在此，我们报告了 1 例 51 岁男性，左肺下叶有肺肿块，纵隔淋巴结肿大。他在经皮肺活检后被诊断为 NSCLC，下一代测序显示棘皮动物微管相关蛋白样 4 基因-间变性淋巴瘤激酶（EML4-ALK）融合变体。患者接受了 5 个月的第二代 ALK-TKI 恩沙替尼新辅助治疗，随后通过单孔电视辅助胸腔镜手术成功进行了肺叶切除术，并辅助恩沙替尼治疗。据我们所知，很少有 ALK 阳性 NSCLC 患者接受过恩沙替尼的新辅助治疗。该患者的发现可能会拓宽可切除 II 期-IIIA 期 ALK 阳性 NSCLC 患者接受新辅助靶向治疗的适应证。
