Alectinib, a highly selective inhibitor of anaplastic lymphoma kinase (ALK), has shown a high response rate and long progression-free survival in primary treatment of ALK-positive non-small-cell lung cancer (NSCLC). De novo resistance or refractory subtype is rare event. Herein, we identify the first case with serial next-generation sequencing (NGS) results that harboured a rare echinoderm microtubule associated protein like 4 gene (EML4) -ALK (breaking site at exon 19) fusion in a lung adenocarcinoma (LUAD) patient who acquired alectinib resistance rapidly (less than 3 months), followed by multi-drug resistance and short survival time.

艾乐替尼是一种高度选择性的间变性淋巴瘤激酶 (ALK) 抑制剂，在 ALK 阳性非小细胞肺癌 (NSCLC) 的初级治疗中显示出高反应率和长无进展生存期。新发耐药或难治亚型是罕见的事件。在这里，我们确定了第一个具有系列下一代测序 (NGS) 结果的病例，该病例在肺腺癌 (LUAD) 患者中含有罕见的棘皮动物微管相关蛋白，如 4 基因 ( EML4 ) -ALK (外显子 19 断裂位点) 融合，该患者获得性艾乐替尼耐药迅速（不到3个月），其次是多药耐药，生存时间短。