1
|
Hu H, Tan S, Xie M, Guo P, Yu Q, Xiao J, Zhao K, Liao Q, Wang Y. Case report: Concomitant EGFR mutation and ALK rearrangement in non-small cell lung cancer. Front Pharmacol 2023; 14:1167959. [PMID: 37705536 PMCID: PMC10495838 DOI: 10.3389/fphar.2023.1167959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 08/01/2023] [Indexed: 09/15/2023] Open
Abstract
In non-small cell lung cancer (NSCLC), two key genetic alterations, epidermal growth factor receptor (EGFR) mutations and anaplastic lymphoma kinase (ALK) rearrangements, are commonly believed to be mutually exclusive. Studies have reported that concurrent EGFR/ALK co-mutation in non-small cell lung cancer patients is rare, with a prevalence ranging from 0.1% to 1.6%. However, the clinical and pathological characteristics of these patients are not well-defined, and the optimal treatment approach for such cases remains controversial. In this report, we present a case of stage IV lung adenocarcinoma with both epidermal growth factor receptor and anaplastic lymphoma kinase mutations, along with high PD-L1 expression. The patient initially received treatment with epidermal growth factor receptor tyrosine kinase inhibitors (TKIs), but the disease progressed. However, following a switch to ALK-TKI therapy and local radiotherapy, the lesion showed regression. Our report also provides a comprehensive summary of the clinical and pathological features, as well as treatment strategies, for non-small cell lung cancer patients with concurrent epidermal growth factor receptor mutation and anaplastic lymphoma kinase rearrangement.
Collapse
Affiliation(s)
- Haoyue Hu
- Department of Radiation Oncology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China
| | - Songtao Tan
- West China School of Medicine, Sichuan University, Chengdu, China
- Department of Cleft Lip and Palate, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shijingshan, Beijing, China
| | - Meng Xie
- Department of Pharmacy, Southwest Medical University, Luzhou, China
| | - Peng Guo
- Department of Pathology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China
| | - Qiang Yu
- Department of Radiation Oncology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China
- Dazhou Quxian People’s Hospital, Dazhou, China
| | - Juan Xiao
- Department of Radiation Oncology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China
| | - Kangrui Zhao
- Department of Radiation Oncology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China
| | - Qiong Liao
- Department of Pathology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China
| | - Yi Wang
- Department of Radiation Oncology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China
| |
Collapse
|
2
|
Kanbe M, Sunaga N, Hara K, Sawada H, Wakamatsu I, Hara K, Muto S, Sawada Y, Masubuchi H, Sato M, Miura Y, Tsurumaki H, Yatomi M, Sakurai R, Koga Y, Ohtaki Y, Nagashima T, Okano N, Kubo N, Maeno T, Hisada T. Durable response to afatinib rechallenge in a long-term survivor of non-small cell lung cancer harboring EGFR L858R and L747V mutations. Thorac Cancer 2022; 13:3225-3228. [PMID: 36193787 PMCID: PMC9663673 DOI: 10.1111/1759-7714.14678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 09/16/2022] [Accepted: 09/17/2022] [Indexed: 01/07/2023] Open
Abstract
Epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors are standard therapeutic agents for non-small cell lung cancer (NSCLC) patients with major EGFR mutations such as exon 19 deletions and a L858R mutation, whereas treatment strategies for cases with uncommon EGFR mutations remain to be fully established. Here, we report a long-term (≥20 years from initial diagnosis) NSCLC survivor carrying EGFR L858R and L747V mutations. The patient received gefitinib monotherapy, systemic chemotherapy/chemoimmunotherapy, and local consolidative therapies for oligometastatic lesions, and responded to afatinib rechallenge with a progression-free survival of 12 months. The current case suggests that afatinib is effective in NSCLC patients with EGFR L858R and L747V mutations and that a therapeutic approach combining appropriately timed systemic therapies with local consolidative therapies for oligometastatic lesions improves long-term survival.
Collapse
Affiliation(s)
- Mio Kanbe
- Department of Respiratory MedicineGunma University Graduate School of MedicineMaebashiGunmaJapan
| | - Noriaki Sunaga
- Department of Respiratory MedicineGunma University Graduate School of MedicineMaebashiGunmaJapan
| | - Kenichiro Hara
- Department of Respiratory MedicineGunma University Graduate School of MedicineMaebashiGunmaJapan
| | - Hiiru Sawada
- Department of Respiratory MedicineGunma University Graduate School of MedicineMaebashiGunmaJapan
| | - Ikuo Wakamatsu
- Department of Respiratory MedicineGunma University Graduate School of MedicineMaebashiGunmaJapan
| | - Kentaro Hara
- Department of Respiratory MedicineGunma University Graduate School of MedicineMaebashiGunmaJapan
| | - Sohei Muto
- Department of Respiratory MedicineGunma University Graduate School of MedicineMaebashiGunmaJapan
| | - Yuri Sawada
- Department of Respiratory MedicineGunma University Graduate School of MedicineMaebashiGunmaJapan
| | - Hiroaki Masubuchi
- Department of Respiratory MedicineGunma University Graduate School of MedicineMaebashiGunmaJapan
| | - Mari Sato
- Department of Respiratory MedicineGunma University Graduate School of MedicineMaebashiGunmaJapan
| | - Yosuke Miura
- Department of Respiratory MedicineGunma University Graduate School of MedicineMaebashiGunmaJapan
| | - Hiroaki Tsurumaki
- Department of Respiratory MedicineGunma University Graduate School of MedicineMaebashiGunmaJapan
| | - Masakiyo Yatomi
- Department of Respiratory MedicineGunma University Graduate School of MedicineMaebashiGunmaJapan
| | - Reiko Sakurai
- Oncology CenterGunma University HospitalMaebashiGunmaJapan
| | - Yasuhiko Koga
- Department of Respiratory MedicineGunma University Graduate School of MedicineMaebashiGunmaJapan
| | - Yoichi Ohtaki
- Department of General Surgical ScienceGunma University Graduate School of MedicineMaebashiGunmaJapan
| | - Toshiteru Nagashima
- Department of General Surgical ScienceGunma University Graduate School of MedicineMaebashiGunmaJapan
| | - Naoko Okano
- Department of Radiation OncologyGunma University Graduate School of MedicineMaebashiGunmaJapan
| | - Nobuteru Kubo
- Department of Radiation OncologyGunma University Graduate School of MedicineMaebashiGunmaJapan
| | - Toshitaka Maeno
- Department of Respiratory MedicineGunma University Graduate School of MedicineMaebashiGunmaJapan
| | - Takeshi Hisada
- Gunma University Graduate School of Health SciencesMaebashiGunmaJapan
| |
Collapse
|
3
|
Lei Y, Lei Y, Shi X, Wang J. EML4‑ALK fusion gene in non‑small cell lung cancer (Review). Oncol Lett 2022; 24:277. [PMID: 35928804 PMCID: PMC9344266 DOI: 10.3892/ol.2022.13397] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 06/13/2022] [Indexed: 11/29/2022] Open
Abstract
Non-small cell lung cancer (NSCLC) is a malignant tumor with a high morbidity and mortality rate that is a threat to human health. With the development of molecular targeted research, breakthroughs have been made on the molecular mechanism of lung cancer. The echinoderm microtubule-associated protein-like 4-anaplastic lymphoma kinase (EML4-ALK) fusion gene is one of the most important pathogenic driver genes of NSCLC discovered thus far. Four generations of targeted drugs for EML4-ALK have been developed, with patients benefiting significantly from these drugs. Therefore, EML4-ALK has become a research hotspot in NSCLC. The aim of the present study is to introduce the current research progress of EML4-ALK and its association with NSCLC.
Collapse
Affiliation(s)
- Yu Lei
- Department of Pathology, Qianjiang Central Hospital, Qianjiang, Hubei 433100, P.R. China
| | - Yan Lei
- Department of Respiratory Medicine, Qianjiang Central Hospital, Qianjiang, Hubei 433100, P.R. China
| | - Xiang Shi
- Department of Pathology, Qianjiang Central Hospital, Qianjiang, Hubei 433100, P.R. China
| | - Jingjing Wang
- Department of Pathology, Qianjiang Central Hospital, Qianjiang, Hubei 433100, P.R. China
| |
Collapse
|