期刊
JOURNAL OF THORACIC ONCOLOGY
卷 9, 期 12, 页码 1821-1825出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/JTO.0000000000000368
关键词
HIP1-ALK; ALK I1171N; ALK I1171S; Alectinib resistance; ALK-rearranged NSCLC; Next generation sequencing; Hydrophobic regulatory spine.
Huntingtin-interacting protein 1 (HIP1) has recently been identified as a new fusion partner fused to anaplastic lymphoma kinase (ALK) in non-small-cell lung cancer (NSCLC). To date, two variants of HIP1-ALK (H21; A20) and (H28; A20) have been identified in NSCLC. However, the response of patients with NSCLC harboring HIP1-ALK to ALK inhibitors and potential resistance mechanisms to such remain unknown. Here, we report a patient with NSCLC harboring a novel HIP1-ALK fusion variant (H30; A20). This patient and another patient with EML4-ALK variant 3a/b initially responded sequentially to crizotinib and then alectinib, a next-generation ALK inhibitor, but developed acquired resistance to alectinib with the presence of a mutation in amino acid residue 1171 (I1171N and I1171S respectively) located in the hydrophobic regulatory spine (R-spine) of the ALK kinase in both the cases as identified by a comprehensive next-generation sequencing-based assay performed on biopsies of new liver metastases that developed during alectinib treatment.
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