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:
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      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.