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Successful management of lung adenocarcinoma with ALK/EGFR co-alterations and PD-L1 over-expression by bevacizumab combined with chemotherapy

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Abstract

Anaplastic lymphoma kinase (ALK)/epidermal growth factor receptor (EGFR) co-alterations in adenocarcinomas are rare and no therapeutic consensus is reached. The potentially negative prognostic effects of programmed death-ligand 1 (PD-L1) expression on tyrosine kinase inhibitor (TKIs) efficacy further complicates the treatment options for patients with ALK/EGFR co-alterations and PD-L1 over-expression. We describe a case of advanced lung adenocarcinoma, harboring concurrent ALK/EGFR mutations and extremely high PD-L1 expression, that achieved sustained remission by the first-line treatment strategy of antiangiogenic therapy combined with chemotherapy. It is our firm conviction that the use anti-angiogenics should not have fallen out of favor in this era of targeted therapy and checkpoint inhibitors.

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Data availability

The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.

Code availability

Not applicable.

Abbreviations

NSCLC:

Non-small-cell lung cancer

EGFR:

Epidermal growth factor receptor

ALK:

Anaplastic lymphoma kinase

EML4-ALK:

Echinoderm microtubule-associated protein-like 4-anaplastic lymphoma kinase

VEGF:

Vascular endothelial growth factor

TKIs:

Tyrosine kinase inhibitors

PD-L1:

Programmed death-ligand 1

MSS:

Microsatellite-stable

TMB:

Tumor mutation burden

ICIs:

Immune checkpoint inhibitors

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Funding

This work was supported by grants from the National Natural Science Foundation of China (Grant No. 81802984 project to Yuan Peng, Grant No. 81972851 project to Zhenzhou Yang and Grant No. 82002448 project to Xiaoyue Zhang).

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Author notes

  1. Hengqiu He and Wendi Yang contributed equally to this article.

Authors and Affiliations

  1. Department of Cancer Center, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, 400010, China

    Hengqiu He, Wendi Yang, Yusheng Huang, Xiaoyue Zhang, Yuan Peng & Zhenzhou Yang

Authors
  1. Hengqiu He
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  2. Wendi Yang
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  3. Yusheng Huang
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  4. Xiaoyue Zhang
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  5. Yuan Peng
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  6. Zhenzhou Yang
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Contributions

HH prepared the figures, collected the clinical data and wrote the report. WY and XZ collected the clinical data and provided the pathology results. YH contributed to clinical care of the patient. YP designed the study, analysed data, interpreted data and wrote the report. ZY designed the study, did the critical review and finalised the report. Written informed consent to publication was obtained.

Corresponding authors

Correspondence to Yuan Peng or Zhenzhou Yang.

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Conflict of interest

The authors declare no competing interest for this work.

Ethical approval

Personal and clinical data were approved by the Ethics Committees of the corresponding institutions.

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Informed consent was obtained from the patient.

Consent for publication

The patient allowed the authors to publish anonymous data from her medical file.

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He, H., Yang, W., Huang, Y. et al. Successful management of lung adenocarcinoma with ALK/EGFR co-alterations and PD-L1 over-expression by bevacizumab combined with chemotherapy. Angiogenesis 25, 5–8 (2022). https://doi.org/10.1007/s10456-021-09811-8

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  • DOI: https://doi.org/10.1007/s10456-021-09811-8

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