EML4-ALK rearrangement of lung large cell neuroendocrine carcinoma: a case report

被引:3
作者
Chen, Dianjun [1 ,2 ]
Ma, Shuangyue [1 ,2 ]
Sun, Lili [1 ,2 ]
Lang, Yuehong [1 ,2 ]
Yang, Boyan [1 ,2 ,3 ,4 ,5 ,6 ]
机构
[1] Chinese Acad Med Sci & Peking Union Med Coll, Dept Comprehens Oncol, Natl Canc Ctr, Natl Clin Res Ctr Canc,Canc Hosp, Shenzhen, Peoples R China
[2] Chinese Acad Med Sci & Peking Union Med Coll, Shenzhen Hosp, Shenzhen, Peoples R China
[3] Chinese Acad Med Sci & Peking Union Med Coll, Dept Comprehens Oncol, Canc Hosp, Natl Canc Ctr, Beijing, Peoples R China
[4] Chinese Acad Med Sci & Peking Union Med Coll, Dept Comprehens Oncol, Natl Canc Ctr, Natl Clin Res Ctr Canc,Canc Hosp, Shenzhen 518116, Peoples R China
[5] Chinese Acad Med Sci & Peking Union Med Coll, Shenzhen Hosp, Shenzhen 518116, Peoples R China
[6] Chinese Acad Med Sci & Peking Union Med Coll, Dept Comprehens Oncol, Canc Hosp, Natl Canc Ctr, Beijing 100021, Peoples R China
关键词
Lung large cell neuroendocrine carcinoma (L-LCNEC); anaplastic lymphoma kinase (ALK); neuroendocrine tumors (NET); Alectinib; case report; ALK REARRANGEMENT; OPEN-LABEL; CANCER; CHEMOTHERAPY; TUMORS; ADENOCARCINOMA; CRIZOTINIB;
D O I
10.21037/atm-22-6062
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background: Lung large cell neuroendocrine carcinoma (L-LCNEC) is a subtype of lung cancer with a low incidence and a high degree of malignancy. For early stage patients, surgical treatment is limited, and the risk of postoperative recurrence is high. For patients with unresectable or advanced disease, platinum-based chemotherapy is currently the mainstay of treatment, but its efficacy is unsatisfactory. L-LCNEC with the anaplastic lymphoma kinase (ALK) gene mutation is very rare and currently has no standard therapy. In this article, we report the case of a locally advanced L-LCNEC patient with ALK mutations who underwent first-line treatment with alectinib.Case Description: A previously healthy, 46-year-old, non-smoking woman was clinically diagnosed with unresectable locally advanced L-LCNEC. Next generation sequencing (NGS) of the patient's plasma and tumor specimen showed echinoderm microtubule-associated protein-like 4 (EML-4) (exon 13)-ALK (exon 20) fusion with a mutation frequency of 14.48% and 15.37%. The patient refused chemotherapy, and received first-line treatment with alectinib 600 mg, bis in die (bid), per day. After taking alectinib for 1 month, the patient's chest enhanced computed tomography (CT) scan showed a partial response (PR). After 12 months of treatment with alectinib, a radiological evaluation showed that the patient had maintained the PR. A grade 2-3 rash was observed at the beginning of the treatment. After symptomatic treatment, the rash disappeared, and the side effects were fully tolerated. At present, the patient can work normally, has a performance status of 0 and has not experience any major adverse events.Conclusions: Our case suggests that the first-line use of targeted therapy is also a good choice for L-LCNEC patients of stage III with gene mutations. The side effects are light, the patient can tolerate well, and the quality of life of can be improved.
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页数:9
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