Zhang Hao, Xia Wei, Zhang Yifan, Bao Shihao, Zeng Jingtong, Li Xianjie, Zhang Bo, Wang Hanqing, Xu Song, Song Zuoqing
Department of Lung Cancer Surgery, Tianjin Medical University General Hospital, Tianjin, China.
Tianjin Key Laboratory of Lung Cancer Metastasis and Tumor Microenvironment, Lung Cancer, Tianjin, China.
Front Oncol. 2025 Feb 25;15:1474997. doi: 10.3389/fonc.2025.1474997. eCollection 2025.
Anaplastic lymphoma kinase (ALK) inhibitors have shown efficacy in treating ALK-positive advanced non-small cell lung cancer (NSCLC) patients. However, the effectiveness of ensartinib neoadjuvant therapy remains ambiguous. Herein, we reported that preoperative systemic treatment with the ALK inhibitor ensartinib can be beneficial for treating initially inoperable tumors. In this study, we present a case of a 60-year-old female patient who was diagnosed with stage IIIA (cT2aN2aM0, ninth TNM stage) lower left lung adenocarcinoma harboring an EML4-ALK fusion. After three months of therapy, the neoadjuvant treatment with ensartinib provided a partial response, with significant tumor and lymph node shrinkage. Preoperative ensartinib neoadjuvant therapy for NSCLC is safe and effective. Nevertheless, clinical trials can be conducted in the future to validate our results. Moreover, we performed multiple immunofluorescence staining analyses on samples before and after neoadjuvant therapy, observed and compared the changes in the expression of relevant immune cells (CD8+ T cells, macrophages, PD-1, and PD-L1), and performed a simple analysis.
间变性淋巴瘤激酶（ALK）抑制剂已显示出对治疗ALK阳性晚期非小细胞肺癌（NSCLC）患者有效。然而，恩沙替尼新辅助治疗的有效性仍不明确。在此，我们报告术前使用ALK抑制剂恩沙替尼进行全身治疗可能有利于治疗最初无法手术的肿瘤。在本研究中，我们展示了一名60岁女性患者的病例，她被诊断为左下肺腺癌IIIA期（cT2aN2aM0，第九版TNM分期），伴有EML4-ALK融合。经过三个月的治疗，恩沙替尼新辅助治疗产生了部分缓解，肿瘤和淋巴结显著缩小。术前恩沙替尼新辅助治疗NSCLC是安全有效的。尽管如此，未来可以进行临床试验以验证我们的结果。此外，我们对新辅助治疗前后的样本进行了多重免疫荧光染色分析，观察并比较了相关免疫细胞（CD8+T细胞、巨噬细胞、PD-1和PD-L1）表达的变化，并进行了简单分析。
