Crizotinib Response in a Late Relapse of ALK-positive Lung Adenocarcinoma

Area of Science:

• Oncology
• Molecular Diagnostics
• Thoracic Surgery

Background:

• Anaplastic Lymphoma Kinase (ALK) rearrangement is a key target in non-small cell lung cancer (NSCLC).
• Late recurrences of ALK-rearranged NSCLC are infrequently reported, especially concerning sensitivity to ALK inhibitors.
• Understanding treatment responses in late-stage or recurrent disease is crucial for improving patient outcomes.

Observation:

• A 35-year-old male patient with lung adenocarcinoma experienced a late recurrence 10 years after initial surgery and chemotherapy.
• The recurrence, located in the same lobe, was histologically confirmed as lung adenocarcinoma.
• Diagnostic challenges due to inadequate cytologic samples necessitated testing on previous tumor specimens.

Findings:

• ALK rearrangement was confirmed via fluorescence in situ hybridization (FISH) on archival tumor tissue.
• The patient's late-recurrent ALK-positive lung adenocarcinoma demonstrated significant sensitivity to crizotinib therapy.
• This represents the first reported case of a late relapse of ALK-positive lung adenocarcinoma effectively treated with crizotinib.

Implications:

• Crizotinib can be an effective treatment option for patients with late-recurrent, ALK-positive lung adenocarcinoma.
• This case underscores the importance of molecular testing (like ALK status) even in late recurrences.
• Further research into long-term outcomes and treatment strategies for rare ALK-rearranged NSCLC recurrences is warranted.