NTRK and ALK rearrangements in malignant pleural mesothelioma, pulmonary neuroendocrine tumours and non-small cell lung cancer

Objectives: Gene rearrangements involving NTRK1, NTRK2, NTRK3, ROS1 and ALK have been identified in many types of cancer, including non-small cell lung cancer (NSCLC). Data in malignant pleural mesothelioma (MPM), lung neuroendocrine tumors (NETs) and small-cell lung cancer (SCLC) are lacking. Given the activity of NTRK, ROS-1 and ALK inhibitors in tumors harboring gene fusions, we sought to explore such rearrangements in these less common tumors in addition to NSCLC. Conclusions: To our knowledge, we report for the first time NTRK and ALK rearrangements in a small subset of MPM. An ALK rearrangement was also detected in lung intermediate-grade NET (or atypical carcinoid). Our data suggest that IHC could be a useful screening test in such patients to ensure that all therapeutic strategies including targeted therapy are utilized. READ ARTICLE

Lung Cancer DOI:10.1016/j.lungcan.2020.05.019

Authors: Jose Luis Leal, Geoffrey Peters, Marcin Szaumkessel, Trishe Leong, Khashayar Asadi, Gareth Rivalland, Hongdo Do, Clare Senko, Paul L.Mitchell, Chai Zi Quing, Alexander Dobrovic, Bibhusal Thapa, Thomas John

Case StudyKirk SmithAugust 1, 2020Mesothelioma, NTRK, ALK, Lung neuroendocrine tumors, Non-small cell lung cancer

Impressive clinical response to anti-PD-1 therapy in epithelioid mesothelioma with high clonal PD-L1 expression and EML4-ALK rearrangement

Objectives: Treatment options for malignant pleural mesothelioma (MPM) are limited but some studies on immune checkpoint inhibitors (ICIs) in MPM have reported antitumor activity. Very little is known about immune-related predictive factors. Conclusions: Our findings indicate that the use of immunotherapy in MPM warrants further investigation. Furthermore, the impressive clinical response obtained by our patient suggests that immune checkpoint inhibitors could help in the management of the disease after the failure of other treatments. READ ARTICLE

Lung Cancer DOI:10.1016/j.lungcan.2020.02.006

Authors: Giuseppe Bronte, Angelo Delmonte, Marco Angelo Burgio, Alberto Verlicchi, Maurizio Puccetti, Sara Bravaccini, Paola Cravero, Maria MaddalenaTumedei, Danila Diano, Giulio Rossi, Paola Ulivi, Giovanni Martinelli, Lucio Crinòa

Case StudyKirk SmithApril 1, 2020Mesothelioma, PD-L1, Immunotherapy, Immune checkpoint inhibitors, EML4-ALK