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Remarkable response to crizotinib in a patient with advanced lung adenocarcinoma harboring the MPRIP-ROS1 fusion
Yasuyuki Kishikawa1, Kohei Otsubo1, Daisuke Shibahara1
1Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
Abstract:
For patients with advanced non-small cell lung cancer (NSCLC), genetic testing is crucial to identify alterations in targetable driver genes. ROS1-tyrosine kinase inhibitors have shown efficacy against NSCLC with common ROS1 fusion genes, but the impact of rare fusion partners on therapeutic outcomes is not well understood. Here, we describe a 75-year-old female with advanced lung adenocarcinoma who was treated with crizotinib after the identification of the extremely rare MPRIP-ROS1 fusion. Despite stepwise dose reductions due to adverse effects, the patient exhibited a significant tumor response to crizotinib. The sustained response, even at reduced doses, highlights the potential for targeted therapies in managing NSCLC with MPRIP-ROS1 fusion. This case also underscores the importance of comprehensive genomic profiling using hybrid capture-based next-generation sequencing to identify rare driver gene alterations that may not be detected by conventional target sequencing-based methods.
Insights
This case study shows a rare MPRIP-ROS1 fusion in advanced non-small cell lung cancer (NSCLC). Crizotinib demonstrated significant tumor response, highlighting targeted therapy potential for rare fusions.
Area of Science:
- Oncology
- Genetics
- Pharmacology
Background:
- Genetic testing is vital for advanced non-small cell lung cancer (NSCLC) to identify targetable driver alterations.
- ROS1-tyrosine kinase inhibitors (TKIs) are effective for common ROS1 fusions, but rare fusion partners' impact remains unclear.
Observation:
- A 75-year-old female with advanced lung adenocarcinoma presented with an extremely rare MPRIP-ROS1 fusion.
- The patient received crizotinib, a ROS1-TKI, for treatment.
Findings:
- Despite dose reductions due to adverse effects, the patient achieved a significant tumor response to crizotinib.
- The sustained efficacy of crizotinib, even at lower doses, was observed in this case of MPRIP-ROS1 fusion.
Implications:
- This case suggests that targeted therapies like crizotinib may be effective for NSCLC harboring the MPRIP-ROS1 fusion.
- Comprehensive genomic profiling, particularly hybrid capture-based next-generation sequencing, is crucial for detecting rare driver gene alterations in NSCLC.
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