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A novel SOS1-ALK fusion variant in a patient with metastatic lung adenocarcinoma and a remarkable response to crizotinib.
Lung Cancer ( IF 4.5 ) Pub Date : 2020-02-21 , DOI: 10.1016/j.lungcan.2020.02.012 Hua-Fei Chen 1 , Wen-Xian Wang 2 , Chun-Wei Xu 3 , Li-Chao Huang 1 , Xiao-Feng Li 1 , Gang Lan 1 , Zhan-Qiang Zhai 1 , You-Cai Zhu 1 , Kai-Qi Du 1 , Lei Lei 2 , Mei-Yu Fang 2
Lung Cancer ( IF 4.5 ) Pub Date : 2020-02-21 , DOI: 10.1016/j.lungcan.2020.02.012 Hua-Fei Chen 1 , Wen-Xian Wang 2 , Chun-Wei Xu 3 , Li-Chao Huang 1 , Xiao-Feng Li 1 , Gang Lan 1 , Zhan-Qiang Zhai 1 , You-Cai Zhu 1 , Kai-Qi Du 1 , Lei Lei 2 , Mei-Yu Fang 2
Affiliation
OBJECTIVES
Transforming anaplastic lymphoma kinase (ALK) gene rearrangements are well known as a unique subset of non-small cell lung cancer (NSCLC) with mutations other than EGFR. Currently, crizotinib is the standard first-line treatment for ALK-positive NSCLC.
MATERIALS AND METHODS
With advances in detection methods, more and more uncommon ALK fusion partners have been identified. Herein we present a novel SOS1-ALK fusion and the efficacy of crizotinib in an advanced NSCLC patient harboring this type of fusion.
RESULTS
A 52-year-old Chinese man had left upper lobe primary NSCLC and synchronous multiple lung metastases (cT2N3M1, stage IV). The ultrasound-guided fine-needle aspiration cytology of palpable left supraclavicular lymph nodes and the results of immunohistochemistry staining supported the diagnosis of metastatic lung adenocarcinoma. Using a next-generation sequencing assay (NGS), we showed that the tumor had a SOS1-ALK fusion which the breakpoints was (S2, A20) rather than other actionable mutations. Therefore, the patient received first-line crizotinib and experienced a remarkable tumor response and has tolerated crizotinib well until this writing.
CONCLUSION
Considering this rare SOS1-ALK fusion and remarkable response to an ALK-inhibitor, it is important to be aware of the presence of SOS1-ALK fusions in patients with advanced NSCLC to better guide targeted therapy. Precision methods, such as NGS for oncogenic alteration detection, should also be encouraged in clinical practice.
更新日期：2020-02-21
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