Xianjin Xie1, Xudong Chen1, Ningning Luo2,3,4, Yingxue Qi2,3,4, Mengmeng Li2,3,4, Xiaoya Feng5. 1. Department of Respiratory Medicine, Shandong Provincial Third Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China. 2. The Medical Department, Jiangsu Simcere Diagnostics Co., Ltd, Nanjing, China. 3. Nanjing Simcere Medical Laboratory Science Co., Ltd, Nanjing, China. 4. The State Key Lab of Translational Medicine and Innovative Drug Development, Jiangsu Simcere Diagnostics Co., Ltd, Nanjing, China. 5. Department of Respiratory Medicine, Shandong Provincial Third Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China. 582610913@qq.com.
Abstract
BACKGROUND: Anaplastic lymphoma kinase (ALK) tyrosine kinase inhibitors (TKIs) improve outcomes for non-small-cell lung cancer (NSCLC) patients with ALK fusions. Nevertheless, ALK TKI resistance will inevitably occur. Histological transformation is one of the causes of TKI resistance in NSCLC. Reports of ALK-rearranged adenocarcinoma with histological transformation are limited. CASE PRESENTATION: A case of an invasive lung adenocarcinoma patient with ALK rearrangement who experienced histological transformation into sarcomatoid carcinoma after ALK TKI resistance is reported, and ALK fusion, MET amplification and TP53 mutation were detected after transformation. CONCLUSIONS: This case first reported a patient with invasive lung adenocarcinoma harboring ALK rearrangement who underwent histological transformation into sarcomatoid carcinoma after ALK TKI resistance, and MET amplification might represent the cause. After transformation, the patient benefited from targeted therapy combined with chemotherapy, which represents a promising option for patients with sarcomatoid carcinoma transformation.
BACKGROUND: Anaplastic lymphoma kinase (ALK) tyrosine kinase inhibitors (TKIs) improve outcomes for non-small-cell lung cancer (NSCLC) patients with ALK fusions. Nevertheless, ALK TKI resistance will inevitably occur. Histological transformation is one of the causes of TKI resistance in NSCLC. Reports of ALK-rearranged adenocarcinoma with histological transformation are limited. CASE PRESENTATION: A case of an invasive lung adenocarcinoma patient with ALK rearrangement who experienced histological transformation into sarcomatoid carcinoma after ALK TKI resistance is reported, and ALK fusion, MET amplification and TP53 mutation were detected after transformation. CONCLUSIONS: This case first reported a patient with invasive lung adenocarcinoma harboring ALK rearrangement who underwent histological transformation into sarcomatoid carcinoma after ALK TKI resistance, and MET amplification might represent the cause. After transformation, the patient benefited from targeted therapy combined with chemotherapy, which represents a promising option for patients with sarcomatoid carcinoma transformation.
Authors: Nicolas Marcoux; Scott N Gettinger; Grainne O'Kane; Kathryn C Arbour; Joel W Neal; Hatim Husain; Tracey L Evans; Julie R Brahmer; Alona Muzikansky; Philip D Bonomi; Salvatore Del Prete; Anna Wurtz; Anna F Farago; Dora Dias-Santagata; Mari Mino-Kenudson; Karen L Reckamp; Helena A Yu; Heather A Wakelee; Frances A Shepherd; Zofia Piotrowska; Lecia V Sequist Journal: J Clin Oncol Date: 2018-12-14 Impact factor: 44.544
Authors: Freddie Bray; Jacques Ferlay; Isabelle Soerjomataram; Rebecca L Siegel; Lindsey A Torre; Ahmedin Jemal Journal: CA Cancer J Clin Date: 2018-09-12 Impact factor: 508.702