A rare double ALK fusion variant EML4-ALK and CDK15-ALK in lung adenocarcinoma and response to crizotinib: A case report

Medicine (Baltimore). 2020 Nov 6;99(45):e22631. doi: 10.1097/MD.0000000000022631.

Abstract

Rationale: The anaplastic lymphoma kinase (ALK) fusion has been identified to be a driver gene in lung cancer, and serves as important diagnostic and therapeutic targets. Owing to the advanced sequencing technologies, new partner genes of ALK have been constantly detected.

Patient concerns: A 55-year-old Chinese woman went to our hospital because of cough and expectoration for 1 year. The patient had no fever, chest pain and hemoptysis.

Diagnoses: She was diagnosed with lung adenocarcinoma. Because she had no operational condition, combination chemotherapy with docetaxel and cisplatin (CP) for 4 cycles was adopted. However, computed tomography (CT) scan indicated progression disease (PD). To explore possibility of targeted therapy, the tumor samples were subjected to next-generation sequencing (NGS), and a rare double ALK fusion variant EML4-ALK and CDK15-ALK was identified.

Interventions and outcomes: The patient subsequently received crizotinib treatment, and achieved partial response (PR). No significant drug related adverse reactions were found during crizotinib treatment. The progression-free survival achieved 23 months.

Lessons: Together, we identified a rare double ALK fusion variant, EML4-ALK and CDK15-ALK, in a patient with lung adenocarcinoma. The patient benefited from crizotinib treatment, which could provide a certain reference for the patients with such gene alteration.

Publication types

  • Case Reports

MeSH terms

  • Adenocarcinoma of Lung / diagnostic imaging
  • Adenocarcinoma of Lung / drug therapy*
  • Adenocarcinoma of Lung / genetics*
  • Anaplastic Lymphoma Kinase / genetics*
  • Antineoplastic Agents / therapeutic use*
  • Crizotinib / therapeutic use*
  • Cyclin-Dependent Kinases / genetics*
  • Disease Progression
  • Female
  • Humans
  • Middle Aged
  • Oncogene Proteins, Fusion / genetics*
  • Tomography, X-Ray Computed

Substances

  • Antineoplastic Agents
  • EML4-ALK fusion protein, human
  • Oncogene Proteins, Fusion
  • Crizotinib
  • ALK protein, human
  • Anaplastic Lymphoma Kinase
  • CDK15 protein, human
  • Cyclin-Dependent Kinases