Tingting Feng1, Zhongzhong Chen1, Jianjun Gu2, Yuxiu Wang1, Jun Zhang2, Lingfeng Min3. 1. Department of Respiratory and Critical Care Medicine, Northern Jiangsu People's Hospital, The First Clinical College of Dalian Medical University, Yangzhou 225001, Jiangsu, China. 2. Department of Respiratory and Critical Care Medicine, Northern Jiangsu People's Hospital, Clinical Medical College of Yangzhou University, Yangzhou 225001, Jiangsu, China. 3. Department of Respiratory and Critical Care Medicine, Northern Jiangsu People's Hospital, The First Clinical College of Dalian Medical University, Yangzhou 225001, Jiangsu, China. Electronic address: minlingfeng@126.com.
Abstract
OBJECTIVES: Anaplastic lymphoma kinase (ALK) has been proven to be another driver oncogene that accounts for 3%-7% of non-small-cell lung cancer, and it is more common in young patients and nonsmokers. ALK rearrangements have been previously identified in about 5.1% of lung adenocarcinoma, including EML4-ALK fusion variants, KIF5B-ALK and TFG-ALK. However, a TNIP2-ALK fusion has not been reported in lung adenocarcinoma. Herein, we described a rare case of ALK-rearranged lung adenocarcinoma responding to crizotinib. MATERIALS AND METHODS: Immunohistochemistry (IHC) assay and comprehensive next-generation sequencing (NGS) were performed on the aspirated biopsied tumor tissue. RESULTS: The IHC analysis revealed an ALK-positive tumor, while NGS detected a TNIP2-ALK fusion. The patient achieved continuous remission after treatment with crizotinib (250 mg, twice a day). CONCLUSION: This case provides valuable information on the response to crizotinib of patients with TNIP2-ALK fusion and better understanding of ALK-TKI applications in the future. NGS is a new method that can offer effective detection of gene fusion and gene mutations.
OBJECTIVES:Anaplastic lymphoma kinase (ALK) has been proven to be another driver oncogene that accounts for 3%-7% of non-small-cell lung cancer, and it is more common in young patients and nonsmokers. ALK rearrangements have been previously identified in about 5.1% of lung adenocarcinoma, including EML4-ALK fusion variants, KIF5B-ALK and TFG-ALK. However, a TNIP2-ALK fusion has not been reported in lung adenocarcinoma. Herein, we described a rare case of ALK-rearranged lung adenocarcinoma responding to crizotinib. MATERIALS AND METHODS: Immunohistochemistry (IHC) assay and comprehensive next-generation sequencing (NGS) were performed on the aspirated biopsied tumor tissue. RESULTS: The IHC analysis revealed an ALK-positive tumor, while NGS detected a TNIP2-ALK fusion. The patient achieved continuous remission after treatment with crizotinib (250 mg, twice a day). CONCLUSION: This case provides valuable information on the response to crizotinib of patients with TNIP2-ALK fusion and better understanding of ALK-TKI applications in the future. NGS is a new method that can offer effective detection of gene fusion and gene mutations.
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