Postoperative Recurrence of ROS1-Rearranged Lung Adenocarcinoma: A Case Series

Postoperative recurrence of c-ros oncogene 1 (ROS1)-rearranged non-small cell lung cancer is rarely reported, and the role of tyrosine kinase inhibitors (TKIs) remains unclear. We retrospectively reviewed four patients with completely resected ROS1-positive lung adenocarcinoma who developed recurrence, three receiving crizotinib. The median disease-free interval was 33.4 months, and the median overall survival from postoperative recurrence and initial surgery was 40.7 and 71.2 months, respectively. Brain metastases were the most common initial recurrence site (75%). Crizotinib showed limited efficacy with a median progression-free survival of 3.5 months. These findings highlight indolent disease behavior but limited TKI benefit, supporting the need for adjuvant trials.