Dramatic response to alectinib in a patient with ALK-rearranged squamous cell lung cancer

Lung cancers with anaplastic lymphoma kinase (ALK) rearrangements are highly sensitive to treatment with ALK tyrosine kinase inhibitors (TKIs). Due to the very low rate of patients with squamous cell carcinoma enrolled in clinical trials, the efficacy of ALK inhibitors in patients with ALK-rearranged squamous cell carcinoma in the lung remains unclear. Herein, we present the case of a 70-year-old female patient with squamous cell lung cancer harboring the echinoderm microtubule-associated protein-like 4 (EML4)-ALK fusion gene. The patient was treated with the ALK-TKI alectinib as first-line regimen and achieved a dramatic response without severe adverse events, demonstrating alectinib as a therapeutic option for patients with ALK-positive squamous cell carcinoma. READ ARTICLE

Thoracic Cancer DOI:10.1111/1759-7714.14092

Authors: Jun Shiihara,Fumiyoshi Ohyanagi,Hikari Amari,Minemichi Toda,Hiroki Tahara,Motoi Yuzawa,Yuki Maeda,Motoko Nomura,Yoshiko Mizushina,Yoshiaki Nagai,Hiromitsu Ohta,Yasuhiro Yamaguchi

Case StudyKirk SmithJuly 29, 2021ALK, squamous cell carcinoma, EML4-ALK. fusion gene, alectinib

ALK Rearrangement Adenocarcinoma with Histological Transformation to Squamous Cell Carcinoma Resistant to Alectinib and Ceritinib

Specific tyrosine-kinase inhibitors (TKIs) are widely used for the treatment of non-small-cell lung cancers with anaplastic lymphoma kinase (ALK) translocations. However, most treated patients eventually develop resistance to the TKIs. The histological transformation into small cell carcinoma is well known to be the underlying mechanism for acquired resistance; however, transformation to squamous cell carcinoma is extremely rare. We, herein, report a case of ALK rearrangement-positive adenocarcinoma that transformed to squamous cell carcinoma after administration of alectinib, and was found to be resistant to ceritinib. READ ARTICLE

OncoTargets and therapy DOI:10.2147/OTT.S236706

Authors: Kaiho T, Nakajima T, Iwasawa S, Yonemori Y, Yoshino I.

Transformation of EML4-ALK fusion-positive adenocarcinoma into squamous cell carcinoma in association with acquired resistance to crizotinib

The development of targeted therapies has revolutionized the treatment of patients with lung cancer, especially non-small-cell lung cancer (NSCLC). Anaplastic lymphoma kinase (ALK) is a research hotspot of molecular targeted therapy for lung cancer. ALK tyrosine kinase inhibitors (TKIs) are highly effective for ALK-rearranged NSCLC-positive patients. These targeted therapies have significant clinical effects; however, they inevitably lead to acquired resistance. In previous studies, the histological transformation after ALK inhibitor treatment was mostly based on small-cell lung cancer (SCLC). The transformation from adenocarcinoma into squamous cell carcinoma in NSCLC after treatment with ALK TKI was extremely rare. This study aimed to report a case of lung cancer with a histological transformation from adenocarcinoma into squamous cell carcinoma after crizotinib treatment, still having the original ALK rearrangement at the molecular level. READ ARTICLE

Lung Cancer DOI:10.1016/j.lungcan.2020.01.001

Authors: Fenfang Wang, Jing Qin, Fajun Xie, Qihuan Wu, Hongyang Lu