Case Report: Locally advanced lung adenocarcinoma with a novel MIR217HG-ALK rearrangement responding to neoadjuvant alectinib
BackgroundAnaplastic lymphoma kinase (ALK) rearrangement is a crucial oncogenic driver in non-small cell lung cancer (NSCLC). ALK tyrosine kinase inhibitors (ALK-TKIs) represent the primary therapeutic option for advanced NSCLC patients with ALK rearrangements. However, the definitive determination...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2025-08-01
|
| Series: | Frontiers in Pharmacology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fphar.2025.1602654/full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849242655184125952 |
|---|---|
| author | Yinyin Xue Yinyin Xue Wen Li Wen Li Kaili Huang Kaili Huang Qinghua Zhou Qinghua Zhou Qiang Wu Qiang Wu |
| author_facet | Yinyin Xue Yinyin Xue Wen Li Wen Li Kaili Huang Kaili Huang Qinghua Zhou Qinghua Zhou Qiang Wu Qiang Wu |
| author_sort | Yinyin Xue |
| collection | DOAJ |
| description | BackgroundAnaplastic lymphoma kinase (ALK) rearrangement is a crucial oncogenic driver in non-small cell lung cancer (NSCLC). ALK tyrosine kinase inhibitors (ALK-TKIs) represent the primary therapeutic option for advanced NSCLC patients with ALK rearrangements. However, the definitive determination of ALK-TKIs sensitivity towards newly identified rare ALK rearrangements remains elusive. Herein, we present a patient with lung adenocarcinoma harboring a novel ALK rearrangement who exhibited major pathological response (MPR) following neoadjuvant treatment with alectinib.Materials and methodsWe conduct immunohistochemistry (IHC) staining with Ventana with D5F3 clone, fluorescence in situ hybridization (FISH, The Vysis ALK Break Apart FISH Probe Kit), and next-generation sequencing (NGS) analyses (Burning Rock, Guangzhou, China) on biopsy sample obtained from the patient.ResultsThe patient, a 66-year-old female, was diagnosed with stage IIIB-N3 adenocarcinoma in the right upper lobe of the lung. NGS testing revealed a previously unreported MIR217HG-ALK rearrangement, which was subsequently confirmed by IHC and FISH. Following 5 months of neoadjuvant treatment with alectinib, the patient underwent the right upper lobectomy and achieved MPR, resulting in disease-free survival (DFS) exceeding 19 months.ConclusionIn this study, we present the first documented case of a patient with lung adenocarcinoma harboring a novel MIR217HG-ALK rearrangement who exhibited favorable response to neoadjuvant alectinib. Our findings suggest that alectinib holds promise as an efficacious therapeutic option for individuals with MIR217HG-ALK rearranged lung adenocarcinoma, thereby offering valuable insights for the clinical management of these patients. |
| format | Article |
| id | doaj-art-54f0a3e429ab4557a73c9ff4e65da613 |
| institution | Kabale University |
| issn | 1663-9812 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pharmacology |
| spelling | doaj-art-54f0a3e429ab4557a73c9ff4e65da6132025-08-20T03:59:45ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122025-08-011610.3389/fphar.2025.16026541602654Case Report: Locally advanced lung adenocarcinoma with a novel MIR217HG-ALK rearrangement responding to neoadjuvant alectinibYinyin Xue0Yinyin Xue1Wen Li2Wen Li3Kaili Huang4Kaili Huang5Qinghua Zhou6Qinghua Zhou7Qiang Wu8Qiang Wu9Department of Radiation Oncology Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, ChinaLung Cancer Center/Lung Cancer Institute, West China Hospital, Sichuan University, Chengdu, Sichuan, ChinaLung Cancer Center/Lung Cancer Institute, West China Hospital, Sichuan University, Chengdu, Sichuan, ChinaDepartment of Medical Oncology Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, ChinaLung Cancer Center/Lung Cancer Institute, West China Hospital, Sichuan University, Chengdu, Sichuan, ChinaDepartment of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, ChinaLung Cancer Center/Lung Cancer Institute, West China Hospital, Sichuan University, Chengdu, Sichuan, ChinaDepartment of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, ChinaDepartment of Radiation Oncology Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, ChinaLung Cancer Center/Lung Cancer Institute, West China Hospital, Sichuan University, Chengdu, Sichuan, ChinaBackgroundAnaplastic lymphoma kinase (ALK) rearrangement is a crucial oncogenic driver in non-small cell lung cancer (NSCLC). ALK tyrosine kinase inhibitors (ALK-TKIs) represent the primary therapeutic option for advanced NSCLC patients with ALK rearrangements. However, the definitive determination of ALK-TKIs sensitivity towards newly identified rare ALK rearrangements remains elusive. Herein, we present a patient with lung adenocarcinoma harboring a novel ALK rearrangement who exhibited major pathological response (MPR) following neoadjuvant treatment with alectinib.Materials and methodsWe conduct immunohistochemistry (IHC) staining with Ventana with D5F3 clone, fluorescence in situ hybridization (FISH, The Vysis ALK Break Apart FISH Probe Kit), and next-generation sequencing (NGS) analyses (Burning Rock, Guangzhou, China) on biopsy sample obtained from the patient.ResultsThe patient, a 66-year-old female, was diagnosed with stage IIIB-N3 adenocarcinoma in the right upper lobe of the lung. NGS testing revealed a previously unreported MIR217HG-ALK rearrangement, which was subsequently confirmed by IHC and FISH. Following 5 months of neoadjuvant treatment with alectinib, the patient underwent the right upper lobectomy and achieved MPR, resulting in disease-free survival (DFS) exceeding 19 months.ConclusionIn this study, we present the first documented case of a patient with lung adenocarcinoma harboring a novel MIR217HG-ALK rearrangement who exhibited favorable response to neoadjuvant alectinib. Our findings suggest that alectinib holds promise as an efficacious therapeutic option for individuals with MIR217HG-ALK rearranged lung adenocarcinoma, thereby offering valuable insights for the clinical management of these patients.https://www.frontiersin.org/articles/10.3389/fphar.2025.1602654/fulllung adenocarcinomaMIR217HG-ALKneoadjuvant alectinibmajor pathological response (MPR)stage IIIB-N3 |
| spellingShingle | Yinyin Xue Yinyin Xue Wen Li Wen Li Kaili Huang Kaili Huang Qinghua Zhou Qinghua Zhou Qiang Wu Qiang Wu Case Report: Locally advanced lung adenocarcinoma with a novel MIR217HG-ALK rearrangement responding to neoadjuvant alectinib Frontiers in Pharmacology lung adenocarcinoma MIR217HG-ALK neoadjuvant alectinib major pathological response (MPR) stage IIIB-N3 |
| title | Case Report: Locally advanced lung adenocarcinoma with a novel MIR217HG-ALK rearrangement responding to neoadjuvant alectinib |
| title_full | Case Report: Locally advanced lung adenocarcinoma with a novel MIR217HG-ALK rearrangement responding to neoadjuvant alectinib |
| title_fullStr | Case Report: Locally advanced lung adenocarcinoma with a novel MIR217HG-ALK rearrangement responding to neoadjuvant alectinib |
| title_full_unstemmed | Case Report: Locally advanced lung adenocarcinoma with a novel MIR217HG-ALK rearrangement responding to neoadjuvant alectinib |
| title_short | Case Report: Locally advanced lung adenocarcinoma with a novel MIR217HG-ALK rearrangement responding to neoadjuvant alectinib |
| title_sort | case report locally advanced lung adenocarcinoma with a novel mir217hg alk rearrangement responding to neoadjuvant alectinib |
| topic | lung adenocarcinoma MIR217HG-ALK neoadjuvant alectinib major pathological response (MPR) stage IIIB-N3 |
| url | https://www.frontiersin.org/articles/10.3389/fphar.2025.1602654/full |
| work_keys_str_mv | AT yinyinxue casereportlocallyadvancedlungadenocarcinomawithanovelmir217hgalkrearrangementrespondingtoneoadjuvantalectinib AT yinyinxue casereportlocallyadvancedlungadenocarcinomawithanovelmir217hgalkrearrangementrespondingtoneoadjuvantalectinib AT wenli casereportlocallyadvancedlungadenocarcinomawithanovelmir217hgalkrearrangementrespondingtoneoadjuvantalectinib AT wenli casereportlocallyadvancedlungadenocarcinomawithanovelmir217hgalkrearrangementrespondingtoneoadjuvantalectinib AT kailihuang casereportlocallyadvancedlungadenocarcinomawithanovelmir217hgalkrearrangementrespondingtoneoadjuvantalectinib AT kailihuang casereportlocallyadvancedlungadenocarcinomawithanovelmir217hgalkrearrangementrespondingtoneoadjuvantalectinib AT qinghuazhou casereportlocallyadvancedlungadenocarcinomawithanovelmir217hgalkrearrangementrespondingtoneoadjuvantalectinib AT qinghuazhou casereportlocallyadvancedlungadenocarcinomawithanovelmir217hgalkrearrangementrespondingtoneoadjuvantalectinib AT qiangwu casereportlocallyadvancedlungadenocarcinomawithanovelmir217hgalkrearrangementrespondingtoneoadjuvantalectinib AT qiangwu casereportlocallyadvancedlungadenocarcinomawithanovelmir217hgalkrearrangementrespondingtoneoadjuvantalectinib |