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Shiroyama T, Tamiya M, Hayama M, et al. A heterochronic genetic change from an EGFR mutation to an ALK rearrangement in a patient with lung adenocarcinoma: a case report. J Thorac Dis. 2016;8(5):E345-8doi: 10.21037/jtd.2016.03.43.
Shiroyama, T., Tamiya, M., Hayama, M., Nishihara, T., Nishida, T., Tanaka, A., Morishita, N., Suzuki, H., Okamoto, N., Kawahara, K., & Hirashima, T. (2016). A heterochronic genetic change from an EGFR mutation to an ALK rearrangement in a patient with lung adenocarcinoma: a case report. Journal of thoracic disease, 8(5), E345-8. https://doi.org/10.21037/jtd.2016.03.43
Shiroyama, Takayuki, et al. "A heterochronic genetic change from an EGFR mutation to an ALK rearrangement in a patient with lung adenocarcinoma: a case report." Journal of thoracic disease vol. 8,5 (2016): E345-8. doi: https://doi.org/10.21037/jtd.2016.03.43
Shiroyama T, Tamiya M, Hayama M, Nishihara T, Nishida T, Tanaka A, Morishita N, Suzuki H, Okamoto N, Kawahara K, Hirashima T. A heterochronic genetic change from an EGFR mutation to an ALK rearrangement in a patient with lung adenocarcinoma: a case report. J Thorac Dis. 2016 May;8(5):E345-8. doi: 10.21037/jtd.2016.03.43. PMID: 27162697; PMCID: PMC4842787.
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J Thorac Dis. 2016 May;8(5):E345-8. doi: 10.21037/jtd.2016.03.43.

A heterochronic genetic change from an EGFR mutation to an ALK rearrangement in a patient with lung adenocarcinoma: a case report.

Journal of thoracic disease

Takayuki Shiroyama, Motohiro Tamiya, Manabu Hayama, Takashi Nishihara, Takuji Nishida, Ayako Tanaka, Naoko Morishita, Hidekazu Suzuki, Norio Okamoto, Kunimitsu Kawahara, Tomonori Hirashima

Affiliations

  1. 1 Department of Thoracic Malignancy, 2 Department of Pathology, Osaka Prefectural Medical Center for Respiratory and Allergic Diseases, Osaka, Japan.

PMID: 27162697 PMCID: PMC4842787 DOI: 10.21037/jtd.2016.03.43

Abstract

An 87-year-old man with postoperative recurrent lung adenocarcinoma was treated with gefitinib. At the beginning of treatment, surgically resected archived tumor tissue revealed a deletion in exon 19 of the EGFR gene, but no ALK gene rearrangement. After gefitinib treatment for 9 months, the disease progressed. Bronchoscopic rebiopsy was used to evaluate resistance mechanisms, and revealed lung adenocarcinoma with wild-type EGFR genes and a newly emerged ALK gene rearrangement. Treatment was switched to alectinib and a partial response was achieved within 4 weeks. This is a rare case of heterochronic genetic change to an ALK gene rearrangement in EGFR mutant lung adenocarcinoma.

Keywords: ALK gene rearrangement; EGFR mutation; alectinib; resistance mechanism

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