Lung cancer remains the leading cause of cancer death world-wide. This is in part due patients presenting late with disseminated disease and despite recent advances, a limited therapeutic landscape... Despite these advances there remains a significant unmet clinical need with much research needed to elucidate the optimal treatment paradigm to improve response rates, mortality and quality of life for patients with advanced NSCLC. READ ARTICLE

Encyclopedia of Respiratory Medicine (Second Edition) DOI:10.1016/B978-0-08-102723-3.00265-1

Authors: Alice Davies, Martin Forster

Lung Adenocarcinoma during Pregnancy: 11-Year Follow-Up

The incidence of lung cancer during pregnancy is rising due to the high rate of smokers in young women and the late mean age of pregnancy; in addition, considering that the patients are young women with a higher incidence of molecular alterations, molecular testing in lung adenocarcinoma should always be performed, even in pregnancy. Here, we report the case of a lung adenocarcinoma diagnosed during pregnancy with a long survival who benefitted from brain radiotherapy, conventional chemotherapy, and ALK TKI-targeted treatment. It reveals the safety of whole brain radiotherapy during pregnancy and consideration of other brain radiation techniques even in palliative cases, which should be personalized and managed by a multidisciplinary team. However, upfront management of brain metastasis in ALK-positive patients remains unresolved. READ ARTICLE

Case Reports in Oncology DOI:10.1159/000508360

Authors: Acosta Rojas A., Collazo-Lorduy A., Remon J., Hernando Requejo O., Jiménez-Munarriz B., Rubio Rodríguez M.C., De Castro J.

SRBD1-ALK, a Novel ALK Fusion Gene Identified in an Adenocarcinoma Patient by Next-Generation Sequencing

... Here, we report a case of adenocarcinoma harboring a novel S1 RNA binding domain 1 (SRBD1)–ALK fusion gene identified accidentally during routine molecular profiling by next-generation sequencing... Without any other oncogenic mutation detected, we speculate that the novel SRBD1-ALK fusion served as a driver mutation of the patient’s disease. And ALK TKIs might be effective in the treatment of tumors with this new fusion gene. READ ARTICLE

Journal of Thoracic Oncology DOI:10.1016/j.jtho.2018.11.027

Authors: Xue Hou, Huamin Xu, Likun Chen

Case StudyKirk SmithApril 1, 2019SRBD1-ALK, ALK Fusion, Adenocarcinoma, Next-Generation Sequencing

Histologic transformation of ALK-rearranged adenocarcinoma to squamous cell carcinoma after treatment with ALK inhibitor

Anaplastic lymphoma kinase (ALK)-rearranged non-small cell lung cancer (NSCLC) treated with ALK tyrosine kinase inhibitor (TKI) eventually acquires resistance to the treatment. However, our current knowledge regarding the resistance mechanisms is based on non-synonymous mutation and amplification in ALK, with the reasons still unknown for nearly half of all such cases. Other than genomic alteration as a resistance mechanism, up to 10% of NSCLC with activating epithelial growth factor receptor (EGFR) mutation showed resistance to EGFR TKI through histologic transformation. Although limited in number, there are cases showing transformed samples retaining the initial genomic alteration, which support lineage transition as a novel resistance mechanism. In this report, we described the first case of squamous cell carcinoma (SCC) transformation from adenocarcinoma (ADC) in NSCLC with ALK rearrangement after treatment with ALK TKI. READ ARTICLE

Lung Cancer DOI:10.1016/j.lungcan.2018.11.027

Authors: Sehhoon Park, Joungho Han, Jong-Mu Sun