A novel SOS1-ALK fusion variant in a patient with metastatic lung adenocarcinoma and a remarkable response to crizotinib. (April 2020)

• Record Type: Journal Article
• Authors: Chen, Hua-fei; Wang, Wen-xian; Xu, Chun-wei; Huang, Li-chao; Li, Xiao-feng; Lan, Gang; Zhai, Zhan-qiang; Zhu, You-cai; Du, Kai-qi; Lei, Lei; Fang, Mei-yu
• Is Part Of: Lung cancer. Volume 142(2020)
• Page Start: 59
• Page End: 62
• Publication Date: 2020-04
• Subjects: Non-Small cell lung cancer -- ALK -- Fusion -- TKI -- Crizotinib; Lungs -- Cancer -- Periodicals; Lung Neoplasms -- Abstracts; Lung Neoplasms -- Periodicals; Poumons -- Cancer -- Périodiques; Lungs -- Cancer; Periodicals; Electronic journals; Electronic journals; 616.99424
• DOI: 10.1016/j.lungcan.2020.02.012
• Languages: English
• ISSNs: 0169-5002

Abstract

Highlights: SOS1-ALK fusion in lung adenocarcinoma is the first reported in the world. NGS is important, more and more novel non-EML4-ALK fusions are identified in lung cancer by NGS. Literature review ALK fusion partner, which have been reported before. Abstract: Objectives: Transforming anaplastic lymphoma kinase ( ALK ) gene rearrangements are well known as a unique subset of non-small cell lung cancer (NSCLC) with mutations other than EGFR . Currently, crizotinib is the standard first-line treatment for ALK-positive NSCLC. Materials and methods: With advances in detection methods, more and more uncommon ALK fusion partners have been identified. Herein we present a novel SOS1-ALK fusion and the efficacy of crizotinib in an advanced NSCLC patient harboring this type of fusion. Results: A 52-year-old Chinese man had left upper lobe primary NSCLC and synchronous multiple lung metastases (cT2N3M1, stage IV). The ultrasound-guided fine-needle aspiration cytology of palpable left supraclavicular lymph nodes and the results of immunohistochemistry staining supported the diagnosis of metastatic lung adenocarcinoma. Using a next-generation sequencing assay (NGS), we showed that the tumor had a SOS1-ALK fusion which the breakpoints was (S2, A20) rather than other actionable mutations. Therefore, the patient received first-line crizotinib and experienced a remarkable tumor response and has tolerated crizotinib well until this writing. Conclusion: Considering this rare SOS1-ALK fusion and remarkable response to an ALK-inhibitor, it is important to be aware of the presence of SOS1-ALK fusions in patients with advanced NSCLC to better guide targeted therapy. Precision methods, such as NGS for oncogenic alteration detection, should also be encouraged in clinical practice.