We wanted to present a case with coexistence of anaplastic lymphoma kinase (ALK) and c-ros oncogene 1 (ROS1) rearrangements that has been in remission for a long time with crizotinib. A 62-year-old nonsmoker male patient was diagnosed with Non-small cell lung cancer. Progression developed 9 months after the treatment, and coexistence of ALK and ROS1 positivity were detected in driver mutation analysis performed with fluorescent in situ hybridization. Crizotinib 2 × 250 mg was started in November 2016. The treatment of the patient, who has been in remission for approximately 55 months since then, continues. Until recently, the use of next-generation sequencing (NGS) was not common, but the more frequent epidermal growth factor receptor, then ALK, and finally ROS1 mutation were studied in tumor tissues. Sometimes ROS1 was not studied because there was not enough tissue left. We think that this rate will increase a little more with the widespread use of NGS from now on. Showing that ALK and ROS1 are positive together, longer survivals can be obtained by choosing therapies that are responsive to both.

中文翻译：

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肺腺癌中 ALK 和 ROS1 重排共存时，克唑替尼治疗的 55 个月无进展生存期：极其罕见的病例和文献综述。

我们想要介绍一个间变性淋巴瘤激酶 (ALK) 和 c-ros 癌基因 1 (ROS1) 重排共存的病例，该病例在使用克唑替尼后已得到长期缓解。一名62岁的不吸烟男性患者被诊断出患有非小细胞肺癌。治疗后 9 个月出现进展，通过荧光原位杂交进行驱动突变分析，检测到 ALK 和 ROS1 阳性共存。克唑替尼 2 × 250 mg 于 2016 年 11 月开始使用。患者的治疗从那时起已持续约 55 个月的缓解期。直到最近，下一代测序 (NGS) 的使用并不常见，但在肿瘤组织中研究了更常见的表皮生长因子受体、然后是 ALK、最后是 ROS1 突变。有时ROS1没有被研究，因为没有留下足够的组织。我们认为，从现在开始，随着 NGS 的广泛使用，这个比率将会增加一些。表明 ALK 和 ROS1 同时呈阳性，通过选择对两者都有反应的疗法可以获得更长的生存期。