With the advent of next‐generation sequencing (NGS) and precision medicine, investigators have determined that tumors from different tissue sources that have the same types of genetic mutations will have a positive response to the same targeted therapy. This finding has prompted us to seek potential therapeutic targets for patients with carcinoma of unknown primary (CUP) using NGS technology. Here, we reported a case of a woman with CUP resistance to chemotherapy. We detected 450 cancer‐related gene alterations using three metastatic tumor specimens and found the presence of EML4 exon13 and ALK exon20 fusion. The tumor did respond to crizotinib, a first‐generation ALK inhibitor. When her tumor progressed, circulating tumor DNA detection revealed ALK L1196 M and G1269A mutation resistance to crizotinib, but she had a response to brigatinib. This case revealed that NGS technology used to detect the genetic alterations in patients with CUP might be a reliable method to find potential ther..... READ ARTICLE
The Oncologist DOI:10.1634/theoncologist.2018-0439
Authors: Peng Zhao, Ling Peng, Wei Wu, Yi Zheng, Weiqin Jiang, Hangyu Zhang, Zhou Tong, Lulu Liu, Ruobing Ma, Liping Wang, Ming Yao, Kai Wang, Weijia Fang, Liming Wu