P8-170: A patient with ALK translocation-positive lung adenocarcinoma in whom an EGFR mutation developed during the treatment with ALK inhibitors

Background: Generally, ALK gene translocation and EGFR gene mutation are mutually exclusive in non-small cell lung cancer (NSCLC). We present a patient with ALK translocation-positive lung adenocarcinoma in whom an EGFR mutation developed during the treatment with an ALK inhibitors.

Case Presentation: A 70-year-old man was diagnosed with Stage IVb (cT2N3M1c) adenocarcinoma of the lung in July 20XX-8. Initial chemotherapy with CDDP+PEM was started in August, and 6 courses were performed with best response of PR. Maintenance therapy was performed for 26 courses. In May 20XX-5, multiple bone metastases emerged and 5 courses of DTX was given as the 2nd-line chemotherapy from July 20XX-5 to May 20XX-4 with the best response of SD until bone metastases developed. A trans-bronchial re-biopsy of the primary tumor in the upper lobe of the right lung revealed the translocation of ALK gene. Crizotinib was started in June as the 3rd-line chemotherapy. In August 20XX-3, multiple brain metastases de..... READ ARTICLE

Respirology DOI:10.1111/resp.14150_682

Authors: Misaki Morishita, Yoshiki Negi, Taiichiro Otsuki, Koji Mikami, Eisuke Shibata, Daisuke Horio, Maiko Niki, Akio Tada, Mayuko Tokuda, Jotaro Kiyota, Toshiyuki Minami, Ryo Takahashi, Takashi Yokoi, Kozo Kuribayashi, Takashi Kijima

Conference PaperKirk SmithNovember 19, 2021ALK and EGFR co-mutation, ALK, EGFR, Co-mutation

Lung adenocarcinoma with concurrent ALK and ROS1 rearrangement: A case report and review of the literatures

ALK and ROS1 are prognostic and predictive tumor markers in non-small cell lung carcinoma (NSCLC), which are more often found in lung adenocarcinomas as with other oncogenes such as EGFR, KRAS, or C-MET. Their positivity is 2.6% and 1.3%, respectively, and patients who have mutations in both genes are extremely rare. Here, we report a 61-year-old male diagnosed with acinar adenocarcinoma, who was shown to have both ALK and ROS1 rearrangements but was EGFR- and C-MET mutation-negative. He was treated surgically and received targeted therapy. Our review of the literature revealed that few such cases of concurrent ALK and ROS1 rearrangements have been reported. This information furthers our understanding of the molecular biology underlying NSCLC which will aid the selection of optimal treatment for patients with more than one driver mutation. READ ARTICLE

Pathology - Research and Practice DOI:10.1016/j.prp.2018.09.028

Authors: Huiyan Deng, Chang Liu, Guoliang Zhang, Xiaoling
Wang, Yueping Liu

Case StudyKirk SmithDecember 1, 2018Lung adenocarcinoma, ALK, ROS1, Co-mutation