Journal
LUNG CANCER
Volume 81, Issue 1, Pages 142-143Publisher
ELSEVIER IRELAND LTD
DOI: 10.1016/j.lungcan.2013.02.018
Keywords
NSCLC; ROS1; Personalized medicine; Lung cancer; Crizotinib
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Funding
- state of North Rhine-Westfalia (NRW), Germany
- EUROPEAN UNION, European Regional Development Fund [FKZ:005-111-0027]
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A 55-year-old Caucasian woman with lung adenocarcinoma stage IV presented with repeated relapse after treatment with cytotoxic chemotherapy (carboplatin, gemcitabine, docetaxel, pemetrexed) and targeted agents (erlotinib, cetuximab, sunitinib). Comprehensive molecular diagnostics (EGFR-, ALK-, RAS-, BRAF-, PIK3CA-, HER2- and DDR2-aberrations) were performed and failed initially to detect any driver mutation. While the patient suffered from rapid deterioration of her general condition, in particular from progressive dyspnea due to lung metastases, we implemented screening for RET- and ROS1 translocations into our molecular diagnostic program based on recent reports of these new molecular subgroups in lung adenocarcinoma. On retesting the patient's tumor sample was found to harbor a ROS1-translocation. The patient was subsequently treated with crizotinib and experienced a pronounced clinical improvement corresponding to a complete metabolic response in 18F-FDG-PET and a good and confirmed partial response in CT (RECIST 1.1). Our case exemplifies the need for rapid implementation of newly discovered rare genetic lung cancer subtypes in routine molecular diagnostics. (C) 2013 Elsevier Ireland Ltd. All rights reserved.
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