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Case Report|Articles in Press, 100489

ALK deletion exons 2-19: case report of a rare ALK inhibitor responsive lung cancer driver oncogene

Open AccessPublished:February 24, 2023DOI:https://doi.org/10.1016/j.jtocrr.2023.100489
ALK deletion exons 2-19: case report of a rare ALK inhibitor responsive lung cancer driver oncogene
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      Abstract:

      ALK internal deletions of non-kinase domain exons occur in 0.01% of lung cancers with ALK genomic aberrations. We report a lung adenocarcinoma with a previously undescribed somatic ALK deletion of exons 2-19 with dramatic and sustained (>23 months) response to alectinib. Our and other reported cases with ALK non-kinase domain deletions (between introns/exons 1 to 19) can display positive results in non-sequencing-based lung cancer diagnostic tests (such as immunohistochemistry) used to screen for more common ALK rearrangements. This case report emphasizes that “ALK-driven” lung cancers should be expanded to encompass those harboring not only ALK rearrangements with other genes but also ALK non-kinase domain deletions.

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      Publication history

      Accepted: February 19, 2023
      Received in revised form: February 17, 2023
      Received: December 16, 2022

      Publication stage

      In Press Journal Pre-Proof

      Footnotes

      CRediT author statement:

      Daniel B. Costa: conceptualization, resources, data curation, writing original draft, writing review & editing, visualization, supervision and funding acquisition

      Paul A. VanderLaan: conceptualization, resources, data curation, writing original draft, writing reviewed & editing and visualization

      Sheida Sharifi: resources, data curation and writing review & editing

      Deepa Rangachari: resources, data curation and writing review & editing

      Soravis A. Osataphan: resources, data curation and writing review & editing

      Emmeline Academia: resources, data curation and writing review & editing

      Zachary R. Schoepflin: resources, data curation and writing review & editing

      (Revision)

      Case of the month

      Funding: This work was funded in part through National Institutes of Health (NIH)/National Cancer Institute (NCI) grant R37 CA218707 (to D. B. Costa)

      Disclosure of Potential Conflicts of interest: DR reports receiving personal fees (consulting fees and honoraria) from TelaDoc Health, DynaMed, and Astra Zeneca; nonfinancial support (institutional research support) from Bristol-Myers Squibb, Novocure, and Abbvie/Stemcentrx; all outside the submitted work. PVL reports personal fees (consulting fees) from Gala Therapeutics, Galvanize Therapeutics, Intuitive Surgical, and Ruby Robotics; all outside the submitted work. DBC reports receiving consulting fees and honoraria from Takeda/Millennium Pharmaceuticals, AstraZeneca, Pfizer, Blueprint Medicines, and Janssen, institutional research support from Takeda/Millennium Pharmaceuticals, AstraZeneca, Pfizer, Merck Sharp and Dohme, Merrimack Pharmaceuticals, Bristol Myers Squibb, Clovis Oncology, Spectrum Pharmaceuticals, Tesaro and Daiichi Sankyo, and consulting fees from Teladoc and Grand Rounds by Included Health; all outside the submitted work. No other conflict of interest is reported.

      Identification

      DOI: https://doi.org/10.1016/j.jtocrr.2023.100489

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      © 2023 Published by Elsevier Inc. on behalf of the International Association for the Study of Lung Cancer.

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