INTRODUCTION: Non-small cell lung cancer (NSCLC) accounts for most lung cancer cases, with anaplastic lymphoma kinase (ALK) rearrangement being a key driver in some instances. The identification of oncogenic drivers in lung cancer has transformed the therapeutic landscape of NSCLC management. Developing and using specific ALK inhibitors have markedly improved clinical outcomes in patients with ALK-positive tumors. CASE DESCRIPTION: A 42-year-old male presented with hoarseness and was diagnosed with lung adenocarcinoma through lymph node biopsy. A positron emission tomography-computed tomography (PET-CT) revealed a right upper lobe mass with extensive nodal metastases. Immunohistochemistry confirmed ALK positivity, and next-generation sequencing identified a novel ALK-IR (intergenic region) rearrangement (19.09% abundance), along with mutations in tumor protein 53 (TP53) and cyclin-dependent kinase inhibitor 2A (CDKN2A). To our knowledge, this is the first report of an ALK-IR rearrangement in NSCLC. The patient was treated with crizotinib (250 mg twice daily), achieving partial remission with symptom resolution and no adverse effects over 17 months. CONCLUSION: This first documented case demonstrates the therapeutic efficacy of crizotinib in ALK-IR rearranged NSCLC, emphasizing the importance of comprehensive molecular profiling in guiding precision oncology.
Ni et al. (Thu,) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: