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Case Report: Malignant peritoneal mesothelioma with TFG-ROS1 fusion responds to crizotinib
Background:
Malignant peritoneal mesothelioma (MPM) is an exceptionally rare tumor type, and its molecular properties are poorly understood. In recent years, gene rearrangement has been found in a subset of MPMs. However, ROS1 rearrangement has not been previously reported in MPM.
Case Presentation:
Here, we present the first case report of MPM with TFG-ROS1 rearrangement in a 56-year-old female with no history of asbestos exposure. The patient did not respond to immunotherapy but exhibited sensitivity to crizotinib with a progression-free survival (PFS) of 6 months. Importantly, we identified ROS1 p.K1991N as a potential acquired drug resistance mutation to crizotinib, suggesting that entrectinib may serve as a targeted therapy to overcome this resistance mechanism.
Conclusion:
ROS1 rearrangement could potentially represent a novel driver mutation in MPM, especially in female adults. This case report illustrates the benefits of molecular detection in MPM and underscores the potential for lessons learned from other solid tumors to inform treatment strategies for rare diseases.
Insights
Malignant peritoneal mesothelioma (MPM) with ROS1 rearrangement is rare. This case report details a TFG-ROS1 rearrangement, response to crizotinib, and a resistance mutation, highlighting targeted therapy potential in MPM.
Area of Science:
- Oncology
- Genetics
- Rare Cancers
Background:
- Malignant peritoneal mesothelioma (MPM) is a rare cancer with poorly understood molecular characteristics.
- Gene rearrangements have been identified in some MPM cases, but ROS1 rearrangement is previously unreported.
- This study focuses on a specific gene rearrangement in MPM.
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