ALK-rearranged lung cancer defines a distinctive molecular cohort of patients whose
outcomes are significantly improved by the availability of ALK inhibitors. Thus, it is imperative
for clinicians to screen appropriate patients for this driver mutation with a molecular testing
platform capable of capturing all ALK fusions. Here, we report a novel VKORC1L1-ALK fusion
and an ALK T1151K resistance mutation detected in a lung cancer patient who had been on
crizotinib for over 8 years. Alectinib induced a dramatic response in this patient demonstrating
its clinical activity against T1151K. This case illustrates the importance of performing repeat
biopsy to explore mechanism(s) of resistance when patients experience disease progression
on an ALK inhibitor. The approach has a direct therapeutic impact particularly when an ALK
resistance mutation is identified. READ ARTICLE
Lung Cancer: Targets and Therapy
DOI:10.2147/LCTT.S186804
Authors: Viola W Zhu, Alexa B Schrock, Thangavijayan Bosemani, Bryan S Benn, Siraj M Ali, and Sai-Hong Ignatius Ou