Case report: complete pathologic response to neoadjuvant ensartinib in locally advanced, ALK-positive lung squamous...

ALK-positive of anaplastic lymphoma kinase (ALK) is rare in lung squamous cell carcinoma (LSCC), with an incidence of less than 1%. The role of neoadjuvant treatment with ALK inhibitors remains understudied. Here, we report the first case of stage IIIB, ALK-positive LSCC that achieved complete pathologic responses (pCR) to neoadjuvant ensartinib. In the current study, EML4-ALK positivity was identified by next-generation sequencing in a case with locally SCC. Rapid partial response was observed after four weeks of ensartinib. The patient continued to receive 6 weeks of ensartinib followed by right upper lobectomy with complete pathological response. To the best of our knowledge, limited data are available regarding the role of ensartinib as a neoadjuvant therapy for ALK-positive, non-small cell lung cancer (NSCLC) patients. Our case provided evidence that locally advanced, ALK-positive LSCC could benefit from neoadjuvant ensartinib, with an impressive response and favorable safety. Our findings may also extend the indications for targeted therapy to the neoadjuvant setting in locally advanced, ALK-positive, resectable LSCC.