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Diverse Resistant Mechanisms Identified Using Serial Next-Generation Sequencing in a Patient With ALK-Rearranged

Stephanie Pei Li Saw1, Darren Wan-Teck Lim2

  • 1Division of Medical Oncology, National Cancer Centre, Singapore.

JTO Clinical and Research Reports
|June 12, 2023
PubMed

Insights

Serial next-generation sequencing (NGS) in ALK-rearranged non-small cell lung cancer (NSCLC) guided treatment, extending survival. Longitudinal profiling proved valuable despite concerns about treatment options and assay sensitivity.

Area of Science:

  • Oncology
  • Genomics
  • Molecular Diagnostics

Background:

  • Next-generation sequencing (NGS) identifies oncogene alterations and resistance mechanisms in cancer.
  • Longitudinal profiling's utility in ALK-rearranged non-small cell lung cancer (NSCLC) is understudied.
  • Concerns exist regarding limited post-progression options and assay sensitivity in ALK-rearranged NSCLC.

Observation:

  • A patient with ALK-rearranged NSCLC underwent serial tissue and plasma NGS after disease progression.
  • The patient had concerns regarding limited treatment options and assay sensitivity.

Findings:

  • Serial NGS profiling guided subsequent treatment sequencing.
  • This approach contributed to an overall survival exceeding 8 years from metastatic disease diagnosis.

Implications:

  • Longitudinal NGS profiling can be valuable in managing ALK-rearranged NSCLC.
  • This case highlights the potential of serial molecular profiling to optimize treatment strategies.
  • Serial profiling may overcome challenges associated with limited treatment options and assay sensitivity.
Keywords:
ALKCase reportNext-generation sequencingNon–small cell lung cancerResistant mechanisms

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