OncoTargets and Therapy (Dec 2021)

Efficacy and Drug Resistance Analysis of ALK Inhibitors in Combination with Stereotactic Body Radiation Therapy for Treating Lung Squamous Carcinoma Patient Harboring EML4-ALK Rearrangement

  • Liang L,
  • Mao M,
  • Wu L,
  • Chen T,
  • Lyu J,
  • Wang Q,
  • Li T

Journal volume & issue
Vol. Volume 14
pp. 5385 – 5389

Abstract

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Long Liang,1 Mian Mao,2 Lei Wu,1 Taiyu Chen,3 Jiahua Lyu,1 Qifeng Wang,1 Tao Li1 1Department of Radiation Oncology, Sichuan Cancer Hospital and Institution, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Radiation Oncology Key Laboratory of Sichuan Province, Chengdu, People’s Republic of China; 2Department of Pharmacy, Sichuan Cancer Hospital & Institute, Sichuan Cancer Centre, School of Medicine, University of Electronic Science and Technology of China, Chengdu, People’s Republic of China; 3Clinical Medical College of Chengdu Medical College, Chengdu, 610500, People’s Republic of ChinaCorrespondence: Tao LiDepartment of Radiation Oncology, Sichuan Cancer Hospital Institution, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, No. 55, 4th Section of Renmin South Road, Chengdu, People’s Republic of ChinaEmail [email protected]: EML4-ALK rearrangement is common in lung adenocarcinoma. The ALK inhibitors remarkably inhibit lung adenocarcinoma and reveal long-term beneficial effects in several patients. Advanced genetic testing technology reveals that EML4-ALK rearrangement has been observed in patients with lung squamous cell carcinoma. In the present study, we report a case of a 53-year-old patient with EML4-ALK rearranged in lung squamous carcinoma; PET/CT scan revealed brain and multiple bone metastases. First-line ALK-TKI combined with local stereotactic body radiation therapy indicated progression-free survival of 9 months. After progressive disease, treatment was switched to lorlatinib, with little efficacy and a total overall survival of 11 months. The emergence of drug resistance revealed that the genetic test result was EML4-ALK fusion (V3a/b variants), indicating a poor prognosis. In this study, we analyzed the treatment efficacy of ALK inhibitors and provided a research basis for the treatment of EML4-ALK rearranged in lung squamous cell carcinoma patients.Keywords: lung squamous cell carcinoma, EML4-ALK rearrangement, alectinib, lorlatinib, SBRT

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