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Updated: Jan 19, 2026
Oncogenic Gene Fusion Detection Using Anchored Multiplex Polymerase Chain Reaction Followed by Next Generation Sequencing
Published on: July 5, 2019
A case of primary pulmonary atypical carcinoid with EML4-ALK rearrangement
Na Liu1, Jingjing Wang1, Xiao Fu1
1Department of Medical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, People's Republic of China.
Abstract:
Targeted therapy has revolutionized the treatment pattern of advanced drive gene mutation positive non-small cell lung cancer (NSCLC). Advanced testing techniques enable physicians to detect these gene alterations in the clinic, thereby offering targeted therapies as treatment options to their patients. In this article, we reported a 52-year-old Chinese female with a pulmonary nodule in her left lower lung. After thoracoscopic lobectomy, a histopathological diagnosis of moderately differentiated atypical carcinoid (AC) was made. Anaplastic lymphoma kinase (ALK) rearrangement was detected, which is a rare phenomenon in AC. After the failure of chemotherapy and radiotherapy, the patient started taking crizotinib, subsequently with ceritinib, and then alectinib. This sequential therapy approach has significant clinical benefits for the patient. This article reviewed the clinical significance and drug resistance mechanism of ALK rearrangement in lung cancer. We also discussed recent and ongoing researches and applications of ALK-tyrosine kinase inhibitors (ALK-TKIs).
Insights
Anaplastic lymphoma kinase (ALK) rearrangement, rare in atypical carcinoid lung cancer, responded well to sequential targeted therapies. This approach offers significant clinical benefits for patients with advanced non-small cell lung cancer (NSCLC).
Area of Science:
- Oncology
- Molecular Biology
- Genetics
Background:
- Targeted therapy has transformed advanced non-small cell lung cancer (NSCLC) treatment, particularly for tumors with specific gene mutations.
- Early detection of gene alterations through advanced diagnostics allows for personalized treatment strategies.
Observation:
- A 52-year-old female presented with a pulmonary nodule, diagnosed as moderately differentiated atypical carcinoid (AC) post-surgery.
- Anaplastic lymphoma kinase (ALK) rearrangement was identified in the AC, a rare occurrence.
- The patient's cancer progressed despite chemotherapy and radiotherapy.
Findings:
- Sequential administration of ALK-tyrosine kinase inhibitors (TKIs)—crizotinib, ceritinib, and alectinib—demonstrated significant clinical benefits.
- This case highlights the efficacy of a sequential targeted therapy approach in managing advanced NSCLC with rare ALK rearrangements in AC.
Implications:
- Understanding the clinical significance and resistance mechanisms of ALK rearrangement is crucial for optimizing lung cancer treatment.
- ALK-TKIs represent a vital therapeutic option for NSCLC patients with ALK alterations, with sequential therapy offering a promising strategy.
- Further research into ALK-TKI applications and resistance mechanisms is warranted to improve patient outcomes in lung cancer.
