Journal
LUNG CANCER
Volume 162, Issue -, Pages 86-89Publisher
ELSEVIER IRELAND LTD
DOI: 10.1016/j.lungcan.2021.10.015
Keywords
Anaplastic lymphoma kinase (ALK); Neurobeachin (NBEA); Echinoderm microtubule-associated protein-like 4 gene (EML4); Non-small cell lung cancer (NSCLC); Case report
Categories
Funding
- National Natural Science Foundation of China [81472782]
- National Key Research and Development Program: The key technology of palliative care and nursing for cancer patients [2017YFC1309201]
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This study reports a novel NBEA-ALK, EML4-ALK double-fusion in an NSCLC patient who responded well to alectinib and showed clinical benefit confirmed by liquid biopsy. The findings suggest that alectinib may be a viable therapeutic option for NSCLC patients with double-ALK fusion, and liquid biopsy can dynamically monitor treatment efficacy.
Objectives: The echinoderm microtubule-associated protein-like 4 gene (EML4) and anaplastic lymphoma kinase gene (ALK) fusion is the most common ALK rearrangements in non-small cell lung cancer (NSCLC). Herein, we firstly report that coexistence of a novel Neurobeachin (NBEA)-ALK, EML4-ALK double-fusion is sensitive to alectinib. Materials and methods: Hematoxylin-eosin staining (HE), fluorescent in situ hybridization (FISH), and nextgeneration sequencing (NGS) was performed on the biopsy sample. Results: The patient responded to alectinib as a second-line treatment and achieved stable disease for 11 months, without significant symptoms of toxicity. Significantly, the liquid biopsy also validated clinical benefit, with the disappearance of NBEA-ALK and EML4-ALK fusion variants. We also provided a comprehensive review of all 50 ALK fusion genes in NSCLC. Conclusion: This is the first report on one patient with a novel NBEA-ALK, EML4-ALK double-ALK fusion beneficial from alectinib. Alectinib may be a viable therapeutic option for NSCLC patients with double-ALK fusion, and liquid biopsy could dynamically monitor clinical curative effect.
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