Transformation of ALK expression and PD-L1 0% to PD-L1 90% only after surgery: the need for rebiopsy in lung cancer patients

Abstract

Christoforos Kosmidis,1 Georgios Koimtzis,1 Dimitrios Giannakidis,1 Nikos Tteralli,1 Stylianos Mantalovas,1 Alexandros Tsakalidis,1 Konstantina Tsopouridou,1 Stefanos Atmatzidis,1 Lazaros Liavas,1 Paul Zarogoulidis2 13rd Department of Surgery, “AHEPA” University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece; 2Department of Pharmacology and Clinical Pharmacology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece Abstract: Lung cancer is still diagnosed at a late stage although novel diagnostic techniques are in use. However, as pharmacogenomics have evolved novel targeted therapies either with tyrosine kinase inhibitors or immunotherapy can be currently used as daily treatment. We present the case of a woman with anaplastic lymphoma-positive expression and programmed death-ligand 1 (PD-L1) 0% score upon diagnosis who underwent therapeutic surgery and represented PD-L1 90% expression, however, without anaplastic lymphoma kinase expression. Transformation of the tumor or new tumor is a question to be answered for this patient and possibly we should try and direct rebiopsies for this group of targeted therapy patients. Keywords: lung cancer, adenocarcinoma, EBUS, PD-L1, ALK

Keywords

• lung cancer
• adenocarcinoma
• EBUS
• PD-L1
• ALK